C5  


JOHNA.SEAVERNS 


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J 


H.  R.  CLEVELAND, 

VETERINARY    SURGEON 

DflNYILLE,        ,..       QUE. 


V\/ebster  Family  Library  of  Veterinary  IVleclicifM 
Cummings  School  of  Veterinary  Medicine  at 
Tufts  University 
200  Westboro  Road 
North  Grafton,  MA  01536 


TEXT    BOOK 


VETERINARY    MEDICINE 


JAMES  LAW,  F.R.C.V.S, 


Director  of  the  New  York  State  Veterinary  College 
Cornell  University,  Ithaca,  N.  Y. 


VOL.  I 


ITHACA 

PtTBLISHED   BY   THE   AUTHOR 

1896 


Cop_vright  by 

JAMES    LA  \V 

1S96 


PRESS    OF 

INDRUS    ii    CHURCH 

ITHACA,    N.    Y. 


PREFACE. 


THvURING  a  long  experience  in  teaching  veterinary  medicine 
-L^  and  surgery  in  Cornell  University,  the  author  felt  the  urgent 
need  of  a  compend  on  the  subject,  written  from  the  American 
standpoint  and  having  special  reference  to  the  American  live  stock 
industry.  This  led  to  the  production  of  the  Farmer's  Veterinary 
Adviser,  which  has  been  well  received,  and  has,  up  to  the  present, 
passed  through  ten  editions  in  the  United  States,  besides  the  un- 
authorized editions  published  in  Canada  and  Great  Britain. 

In  entering  upon  a  larger  field  as  Director  of  the  New  York 
State  Veterinary  College,  and  professor  of  medicine  and  sanitary 
science,  he  aims  at  producing  a  work  which  will  meet  the  needs 
of  the  American  student  and  practitioner.  The  special  phases  of 
animal  pathology  in  America,  the  diseases  peculiar  to  our  soil, 
and  the  parasites  that  prevail  here,  but  are  unknown  in  Europe, 
demand  consideration  from  the  American  point  of  view.  The 
special  features  of  our  breeding,  grazing  and  feeding  industries, 
and  of  the  dairy,  over  our  great  extent  of  territory,  and  the 
varying  influence  of  soil,  water,  climate,  altitude  and  traffic,  the 
scope  and  limitations  of  our  interstate  traffic,  and  our  special  rela- 
tion to  the  old  world  in  the  matter  of  meat  products,  combine  with 
other  conditions  in  demanding  a  somewhat  different  treatment  of 
the  subject  from  that  which  we  find  in  European  publications. 
Then,  too,  the  recent  extraordinary  advances  in  the  field  of 
bacteriology  and  sanitary  science,  which  have  virtually  revolution- 
ized modern  medicine,  and  are  an  earnest  of  .still  greater  advances 
in  the  near  future,  demand  a  work  which  shall,  as  far  as  pos- 
sible, .set  forth  the  present  advanced  status,  and  thus  lay  a  solid 
foundation  to  intelligently  follow,  if  not  to  lead,  in  the  imminent 
advance.  As  a  contribution  to  this,  the  present  volume,  the  first 
of  a  series,  is  offered  to  students,  practitioners  and  scientists  by 
their  friend. 

The  Author. 

New  York  State  Veterinary  College, 

Cornell    University. 

October,  1896. 


VETERINARY   MEDICINE. 


OBJECTS  AND  METHODS  OF  STUDY. 

Pathology — general — special.  Morbid  anatomy.  Pathological  chemistry  ; 
Disease.  Health.  Death — Somatic — partial — necrosis.  Syncope.  Apuoea. 
Asphyxia.     Coma.     Death  from  old  age. 

The  principles  and  practice  of  Veterinary  Medicine  should  em- 
brace all  that  is  known  of  the  causes,  nature,  symptoms,  preven- 
tion and  cure  of  disease  in  domestic  animals.  Incidentallj^  it  in- 
cludes diagnosis  and  prognosis. 

Pathology  is  the  science  which  tells  of  the  causes,  and  nature 
of  disease,  and  the  functional  and  structural  changes  by  which  it 
is  characterized.  In  modern  usage  the  term  pathology  is  under- 
stood to  refer  to  the  intimate  nature  of  disease,  but  this  neces- 
sarily involves  an  enquiry  into  its  sources  and  the  predispositions 
to  its  occurrence  ;  its  phenomena  whether  in  changes  of  function 
or  structure  ;  and  its  results  in  the  form  of  perverted  function, 
structural  changes,  degenerations,  dependent  disorder,  etc.  The 
field  of  pathology  is  further  divided  into  general  pathology  and 
special  patholog3^ 

General  Pathology  treats  of  disease  processes  in  their  generic 
form,  and  as  they  appear  in  many  different  diseases.  Thus 
inflammation  and  fever  are  the  prominent  phenomena  in  a  great 
many  different  diseases  which  differ  in  their  seats,  their  causes, 
manifestations  and  results.  Inflammation  and  fever  are  therefore 
subjects  of  general  pathology.  Similarly  all  forms  of  degen- 
eration— fatt3^,  fibrous,  calcic,  amyloid,  etc.,  are  disease  processes 
found  in  many  different  organs  and  under  very  varied  conditions 
and  they  are  accordingly  included  in  general  pathology.  Hj^per- 
trophy  and  atrophy  are  also  possible  in  every  organic  tissue  irre- 
spective of  kind  or  seat,  they  belong  therefore  to  this  particular 
field. 


2  Veterinary  Medicine. 

Special  Pathology  on  the  contrary  is  confined  to  a  particular 
disease  and  not  only  elucidates  the  causes,  phenomena  and  results 
of  such  disease,  but  seeks  to  do  this  in  such  a  way  as  to  differentiate 
this  malady  from  all  others  however  closely  related  to  it.  Thus 
inflammation  of  a  bone  is  known  under  the  general  name  of 
osteitis,  this  may  be  due  to  a  great  variety  of  different  causes,  and 
each  would  have  its  own  special  pathology.  The  osteitis  of 
simple  mechanical  injury  is  essentially  different  from  the  osteitis 
of  rheumatism,  of  purulent  infection,  of  tuberculosis,  of  actino- 
mycosis. So  with  the  inflammations  of  every  other  tissue.  Each 
ma3^  suffer  from  a  variety  of  inflammations,  springing  from  dif- 
ferent causes,  attended  with  characteristically  unlike  tissue 
changes  and  tending  to  different  issues,  and  every  one  of  these 
forms  has  therefore  its  own  special  pathology. 

General  Pathology  may  be  said  to  deal  with  typical  disease 
processes  to  a  large  extent  irrespective  of  the  individual  disease 
in  which  they  may  appear,  while  Special  Pathology  deals  with 
the  morbid  phenomena  which  distinguishes  the  individual  malady 
from  all  other  diseases  however  closely  allied  to  it. 

Pathological  (Morbid)  Anatomy  deals  with  structural 
changes,  the  cause,  the  accompaniment  or  result  of  disease. 
The.se  morbid  changes  are  microscopic  or  macroscopic.  Both  con- 
stitute morbid  anatomy,  but  the  microscopic  alterations  come 
under  the  spacial  name  of  morbid  (pathological)  histolog3^ 

Pathological  Chemistry  is  that  branch  of  pathology  which 
treats  of  chemical  changes  produced  by  disease  in  the  blood, 
lymph,  tissues,  secretions  and  excretions.  It  demands  a  previous 
knowledge  of  the  condition  of  these  tissues  and  fluids  in  health, 
in  the  particular  genus  of  animal  and  under  the  .same  dietary  and 
environment.  Physiological  Chemistry  is  therefore  an  essential 
prerequisite  to  pathological  chemistry,  just  as  anatomy,  physi- 
ology and  histology  are  indispensable  to  the  appreciation  of  path- 
ology and  morbid  anatomy. 

Disease  is  an  injurious  deviation  from  the  normal  function  or 
structure.  The  morbid  process  resulting  in  disease  is  usually  in 
the  nature  of  a  modification  of  the  normal  or  physiogical  condi- 
tion, so  that  it  is  often  difficult  to  set  the  exact  limits  of  health 
and  disease.  What  is  a  purely  physiological  process  under  given 
conditions,  would  b^  distinctly  pathological  under  others.     The 


Objects  and  Methods  of  Study.  3 

free  kidney  secretion  of  cold  weather  and  the  profuse  perspiration 
of  a  hot  season  are  both  purely  physiological  and  in  the  main 
balance  each  other.  Each  under  its  special  environment  fulfills 
an  essential  work  in  eliminating  from  the  system  toxic  materials 
which  would  prove  hurtful  if  retained,  and  thus  each  is  not  only 
physiological  but  beneficial.  If,  however,  they  occurred,  not  in 
this  mutually  compensatory  manner,  but  simultaneously  in  this 
profusion,  they  might  well  be  dreaded  as  morbid  conditions. 
Again  if  either  were  to  occur  apart  from  its  normal  causative  en- 
vironment, if  for  example  the  polyuria  appeared  in  hot  weather 
and  the  perspiration  in  cold,  the  phenomenon  might  fairly  be- 
called  pathological.  In  any  case  if  the  excessive  secretion  in- 
duced a  lowering  of  the  general  tone  of  health  the  process  would 
be  essentially  a  morbid  one.  In  pronouncing  therefore  upon  a 
morbid  process  one  must  take  fully  into  account  the  correspond- 
ing physiological  process,  the  attendant  conditions,  and  whether 
the  result  is  injurious  or  otherwise. 

The  same  is  true  of  structural  changes.  What  under  given 
conditions  would  be  essentially  a  morbid  structure,  might  under 
other  conditions  be  a  simple  adaptation  to  an  unwonted  environ- 
ment, and  a  means  of  protection  from  injuries  that  would  other- 
wise accrue.  Excessive  growth  of  cuticular  tissue  in  the  epithe- 
lioma, wart  or  corn  is  injurious  and  essentially  pathological,  while 
the  callus  on  the  camel's  knee  or  the  workman's  palm  is  purely 
protective  and  physiological.  The  local  development  of  a  mass 
of  fatty  tissue  in  the  average  man  or  beast  is  a  disease,  but  the 
tendency  to  the  uniform  deposition  of  fat  in  the  connective  tissue 
of  the  improved  breeds  of  meat  producing  animals,  is  the  happy 
culmination  of  a  long  continued  and  skillful  selection  and  regi- 
men, without  which  the  live  stock  industry  of  today  would  be  a 
grievous  failure.  To  constitute  disease,  therefore,  modified  func- 
tion must  be  permanent,  and  not  simply  a  compensating  increase, 
decrease,  or  other  change,  and  it  must  be  in  some  way  injurious 
to  the  animal  economy.  Similarly  to  constitute  disease  modified 
structure  must  be  other  than  a  simple  protection  or  beneficial 
change,  it  must  not  be  a  simple  evolution  in  the  nature  of  accom- 
modation to  the  environment  but  it  must  be  a  cause  of  injury  to 
function  or  a  distinct  deformity. 

Health  may  be  said  to  be  the  harmonious  exercise  and  mutual 


4  Vctermary  Medicine. 

balance  of  all  the  bodily  functions,  and  any  interference  with 
such  mutual  exercise  or  balance  may  be  said  to  constitute  dis- 
ease. But  as  health  passes  into  disease  by  insensible  gradations, 
there  is  of  necessity  an  extensive  borderland  which  often  cannot 
be  allotted  to  one  condition  or  the  other,  but  which  must  often  be 
left  a  disputed  territory. 

Again  certain  animal  constitutions  are  innately  strong  and  ro- 
bust, while  others  are  weak  and  feeble,  yet  the  delicacy  of  the 
latter  cannot  be  set  down  as  actual  disease,  and  by  maintaining  a 
due  balance  between  the  functions,  a  fair  measure  of  health  and 
even  long  life  may  be  secured. 

Death  as  the  result  of  disease  may  be  €\\y\<tx  partial  or  somatic. 

Partial  or  local  death  may  be  molecular  as  in  ulceration,  or 
it  may  affect  an  organ  or  part  of  an  organ,  as  in  necrosis,  spha- 
celus, or  sloughing.  Somatic  death  is  a  loss  of  vitahty  of  the 
entire  body  and  is  manifested  by  a  complete  cessation  of  the  bod- 
ily functions,  including  that  of  nutrition.  Usually  the  arrest  be- 
gins with  one  of  the  great  vital  processes,  in  advance  of  the  oth- 
ers, and  thus  in  different  cases,  we  have  death  beginning  at  the 
hearty  at  the  lungs,  and  at  the  brain. 

Death  from  syncope  or  fainting,  begins  at  the  heart,  which 
loses  its  irritability  or  contractility,  or  is  seized  with  a  tonic 
spasm.  If  there  has  been  lack  of  contractility,  the  heart  is 
found  after  death  in  a  flabby,  soft  condition,  and  quite  frequently 
filled  with  blood.  If  heart-spasm,  it  is  contracted,  firm,  and 
empty  or  nearly  so.  Syncope  may  result  from  severe  nervous 
shock  (emotional),  from  the  electric  current,  from  insolation,  or 
from  heart  sedatives  like  chloroform,  or  nicotine.  It  may,  how- 
ever be  but  the  culmination  of  a  gradually  advancing  debility, 
from  exhausting  diseases,  from  fatty  degeneration  of  the  cardiac 
muscles,  or  from  starvation,  or  anaemia.  Again  the  exhaustion 
coming  from  profuse  haemorrhage,  or  from  violent  over-exertion 
is  a  cause  of  fatal  syncope. 

In  death  beginning  at  the  lungs  (apnoea,  asphyxia,  or  suffo- 
cation), the  blood  failing  to  receive  oxygen  and  to  give  up  its 
carbon  dioxide  is  unable  to  maintain  the  various  functions  of  the 
body  and  the  arrest  of  the  other  vital  processes  speedily  follows. 
The  arrest  of  the  respiratory  process  may  occur  from  nervous 
shock,  but  more  commonly  it  results  from  choking,  strangula- 


Objects  and  Methods  of  Study.  5 

tion,  drowning,  or  the  action  of  irrespirable  gases.  In  diseases 
of  the  heart  and  lungs  it  is  liable  to  occur  from  the  obstruction  of 
the  pulmonary  circulation  and  from  the  depression  of  the  respira- 
tory nervous  centres.  After  death  the  lungs  are  found  gorged 
with  dark  red — almost  black — blood,  which  likewise  distends  the 
right  heart  and  systemic  veins,  and  all  mucous  and  serous 
membranes  have  a  dark  red,  congested  aspect.  When  breathing 
has  been  arrested  by  mechanical  violence  there  are,  first,  active 
contractions  of  the  respiratory  muscles,  but  no  loss  of  conscious- 
ness ;  then  as  the  brain  becomes  charged  with  venous  blood,  con- 
sciousness and  volition  are  lost  and  convulsive  movements  ensue. 
Later  still  there  is  no  respiratory  effort  nor  convulsions,  but  the 
heart  continues  to  beat  for  two  or  three  minutes  longer. 

In  death  beginning  at  the  brain  (Coma)  the  sensory  func- 
tions fail  first,  as  evidenced  by  drowsiness,  stupor,  or  complete  in- 
sensibility, while  the  movement  of  heart  and  lungs  are  still  tem- 
poraril}^  continued.  Pressure  on  the  brain  by  a  fractured  bone 
or  blood  clot,  or  in  cases  of  violent  congestion  or  the  rapid  growth 
of  tumors,  usually  operates  in  this  way.  It  may  also  result  from 
the  direct  action  of  certain  poisons,  like  opium,  belladonna,  or 
chloroform,  or  the  ptomaines  or  toxins  of  bacteria.  Causes  acting 
on  the  brain  may,  however,  lead  to  death  by  syncope  or  asphyxia 
when  the  nerve  centres  presiding  over  circulation  or  respiration 
are  the  first  to  feel  the  full  effects  of  the  pressure  or  poison. 

Death  from  old  age,  with  a  gradual  failure  of  the  natural 
processes  of  nutrition  and  tissue-growth,  and  the  occurrence  of 
atrophy  and  various  degenerations  of  the  organs  is  not  a  common 
occurrence  in  domesticated  animals,  so  that  it  may  be  dismissed 
without  further  notice. 

Actual  somatic  death  is  marked  by  the  cessation  of  breathing 
and  pulse,  the  dilated  pupils  and  semi-closed  eyelids,  the  coldness 
and  pallor  of  the  visible  mucous  membranes  and  skin,  and  the 
clenching  of  the  jaws  with  slight  protrusion  of  the  tongue.  Yet 
these  symptoms  may  be  present  in  S3^ncope  and  it  may  even  be 
impossible  to  detect  the  beats  of  the  heart,  though  the  subject  still- 
lives.  Pressure  of  the  finger  on  a  white  portion  of  the  skin  or  on 
a  mucous  membrane  may  give  a  further  indication.  If  the  in- 
dentation made  by  the  finger  is  slowly  effaced  and  if  the  blood 
again  slightl}^  reddens  the  part  the  presumption  is  against  death. 


6  Veterinary  Medicine. 

Even  this  is  not  infallible,  since  by  pressure  of  gas  in  the  internal 
cavities  or  deeper  blood  vessels,  the  blood  may  be  forced  back 
into  the  surface  capilliaries  giving  an  appearance  of  circulation, 
after  actual  death.  On  the  other  hand  any  exudation  or  oedema 
will  retain  the  imprint  of  the  finger  even  in  life.  The  general 
relaxation  of  the  muscles  and  their  lack  of  response  to  electric 
stimulation,  and  the  setting  in  of  cadaveric  rigidity,  and  later  still 
of  putrefaction  give  more  conclusive  evidence  of  dissolution. 


ETIOLOGY  :  CAUvSEvS  OF  DISEASE. 

Causes— simple — complicated  :  Proximate  ;  Remote  :  Predisposing — race, 
genus,  family,  heredity,  individual,  environment,  food,  age,  sex,  tempera- 
ment, idiosyncrasy,  debility,  plethora,  interdependence  of  organs,  embolism, 
mechanical  influence.  Exciting  causes,  intrinsic,  extrinsic,  inherent,  ac- 
quired, heredity,  dentition,  heat,  cold,  atmospheric  conditions,  electricity, 
moisture,  dryness,  dust,  darkness,  light,  soil,  food,  water,  inaction,  over- 
exertion, mechanical  causes,  poisons, — mineral — vegetable — animal,  mi- 
crobes, contagious,  infectious,  epizootic,  enzootic,  sporadic,  panzootic, 
zymotic,  mediate  contagion,  bacterial  poisons. 

The  causes  of  disease  are  simple  or  complicated,  and  in  the 
latter  case  a  single  factor  may  be  altogether  harmless  unless  asso- 
ciated with  another  which  also  may  have  been  innocuous  alone. 
For  example  :  the  infecting  germ  of  glanders  (Bacillus  Mallei) 
is  harmless  to  the  ox  which  lacks  the  predisposition  to  the  dis- 
ease : — feeding  buckwheat  is  harmless  to  the  dark-skinned  ani- 
mal, but  is  injurious  to  the  white-skinned,  if  exposed  to  sun- 
shine :— the  chicken  can  bear  with  impunity  exposure  to  cold  or 
to  the  bacillus  anthracis,  but  it  cannot  endure  these  two  etiologi- 
cal factors  combined.  It  follows  that  one  cannot  predict  the 
same  result  from  the  same  cause  in  every  case.  Yet  with  all  con- 
current conditions  the  same  the  result  will  follow  with  mathemati- 
cal certainty.  This  will  serve  to  illustrate  the  value  of  thorough- 
ness in  etiological  knowledge,  as  the  basis  of  a  sound  pathology. 

Etiology  is  primarily  divided  into  proximate  and  remote. 
Remote  causes  are  again  divided  into  predisposing  and  exciting. 

Predisposing  Causes  are  such  as  induce  a  condition  of  the 
system  or  of  a  particular  organ  or  group  of  organs  which  renders 
them  specially  susceptible  to  a  disease.  This  may  be  a  character- 
istic of  the  race  ox  genus  of  animal,  thus  the  genus  bovis  alone 
suffers  from  lung  plague,  the  genus  equus  from  dourine,  and 
ruminants  from  Rinderpest.  It  may  be  a  family  trait,  (^heredit- 
ary) hence  we  .see  certain  families  of  both  men  and  cattle  cut  off 
by  tuberculosis,  while  other  adjacent  ones  largely  escape.  It  may 
be  an  individual  peculiarity ,  thus  some  subjects  have  a  congeni- 
tal insusceptibility  to  a  given  disease,  from  which  others  of  the 
same  family  suffer,  and  one  who  has  passed  through  a  self-limit- 


8  Veterinary  Medicine. 

ing  disease  like  measles,  cowpox  or  anthrax  is  rarely  attacked  a 
second  time.  Again  predisposition  may  be  due  to  environment 
as  when  we  find  herds  in  damp  and  exposed  localities  obnoxious 
to  rheumatism,  and  horses  in  dark  mines  exposed  to  specific  oph- 
thalmia. It  may  be  the  result  of  food  as  when  the  flesh-fed  fox 
or  rat  resists  anthrax  and  the  farina-fed  one  falls  a  ready  victim. 
Age  may  predispose,  early  youth  being  remarkably  susceptible  to 
parasitism  and  bacteridian  infection,  and  old  age  to  fractures  and 
degenerations.  Sex  is  inevitably  a  cause  of  limitation  of  disease 
as  the  females  and  males  can  only  suffer  from  disease  of  their 
respective  sexual  organs.  Again  of  diseases  common  to  both 
sexes  certain  nervous  and  digestive  disorders  are  common  in  con- 
nection with  gestation,  and  certain  calculous  diseases  in  connec- 
tion with  the  long  and  narrow  urethra  of  the  male.  Tempera- 
ment has  a  marked  influence,  thus  the  sanguineus  or  nervous 
race-horse  or  hound  shows  a  marked  predisposition  to  diseases  of 
the  heart,  lungs  and  brain,  and  to  a  sthenic  type  of  inflammation 
and  fever,  while  the  heavy  lymphatic  draught-horse  has  a  pro- 
clivity to  diseases  of  the  lymphatics  and  skin.  Idiosyncrasy  is 
closely  allied  to  temperament,  but  the  condition  may  be  less 
manifest,  and  the  peculiarity  is  only  recognized  by  the  results,  as 
when  a  man  is  poisoned  by  sound  fish  or  raspberries.  Debility 
whether  from  deficiency  or  poor  quality  of  food,  on  the  one  hand, 
or  from  overwork,  filth,  dampness  or  disease  on  the  other  must 
be  looked  upon  as  strongly  predisposing  to  certain  diseases,  such 
as  tuberculosis  and  glanders.  Plethora  which  charges  the  blood 
and  tissues  in  a  different  way  with  effete  organic  products,  lays 
the  system  especially  open  to  certain  diseases  like  black  quarter 
in  young  cattle,  and  parturition  fever  in  cows.  Disease  of  one 
organ  often  predisposes  another  organ  through  interdependence 
of  function,  as  when  torpid  or  congested  liver  leads  to  portal  and 
intestinal  congestion,  diseased  teeth  to  digestive  disorder,  im- 
perfect haematosis  to  kidney  trouble  ;  in  other  cases  blood  clots  or 
bacteria  from  one  pathological  centre  may  be  arrested  in  the  blood 
vessels  of  a  distant  organ  and  start  new  foci  of  disease  (embol- 
ism, metastasis)  ;  in  still  other  cases  the  impairment  of  the 
healthy  function  in  one  organ  acts  injuriously  on  another,  as 
when  emphysema  or  other  disease  of  the  lungs  forces  the  blood 
back  upon  the  heart  causing  dilation  with  atrophy  of  the  walls. 


Etiology  :    Causes  of  Disease.  9 

PrevioiLs  disease  in  a  tissue  leaves  for  a  time  an  impairment  of 
structure  and  function  which  may  become  the  essential  predis- 
posing cause  of  the  effective  operation  of  a  morbific  factor.  Me- 
chanical  action  on  a  part  may  predispose  to  disease,  as  for  ex- 
ample, by  reducing  its  circulation  and  nutrition  and  thereby  di- 
rectly impairing  its  power  of  resistance  to  other  inimical  agencies. 
Not  infrequently  a  pus  microbe  lies  deep  in  the  cuticle  or  even  in 
the  tissues  without  harm,  until  there  occurs  a  bruise,  or  a  bony 
fracture  when  it  at  once  develops  a  focus  of  purulent  infection 
(abcess). 

Exciting  Causes  are  the  immediate  causes  of  particular  dis- 
eases. Like  the  predisposing  causes  they  may  be  intrinsic  or 
extrinsic,  and  the  first  may  be  inherent  or  acquired. 

Among  inherent  causes  are  certain  of  those  already  named  as 
predi-sposing  causes,  but  which  have  come  to  be  forcible  enough 
to  develop  disease  without  the  intervention  of  any  other  observa- 
ble factor.  Thus  a  hereditary  monstrosity  (redundancy  or  de- 
fect), will  appear  in  successive  generations  without  any  apparent 
additional  cause.  The  appearance  of  white  calves  in  herds  of 
black  cattle,  after  the  whitewashing  of  their  stables  shows  a 
similar  hereditary  operation  though  the  result  is  not  in  this  case 
pathological.  The  birth  of  blind  foals  from  blind  sires  or  dams, 
or  of  foals  with  distorted  feet  from  mares  suffering  from  severe 
chronic  foot  lameness  are  true  pathological  sequences,  in  which 
the  exciting  cause  is  hereditary  and  operates  during  intrauterine 
life.  Deyitition,  as  an  attendant  on  early  life  is  often  a  directly 
exciting  cause,  from  direct  injury  by  entangled  or  retained  teeth 
that  should  have  been  shed,  by  fever  aroused  by  the  active  local 
changes,  or  imperfect  mastication  or  insalivation  leading  to  con- 
sequent indigestion  ;  in  puppies  and  kittens  convulsions  are  not 
uncommon  as  a  result. 

Extrinsic  Causes  are  such  as  operate  through  the  environ- 
ment. Heat,  if  excessive  and  prolonged,  relaxes  and  exhausts 
the  system  and  exerts  a  direct  influence  on  the  process  of  sangui- 
fication so  that  it  may  become  the  direct  cause  of  a  variety  of 
diseases.  As  the  result  of  extensive  burns,  dangerous  congestions 
of  internal  organs  are  liable  to  occur,  a  nd  even  the  prolonged 
heat  of  summer  often  superinduces  hepatic  and  gastric  disorder, 
diarrhoea  and  dysentery.     Fat  cattle  in  uncovered  cars  or  yards 


lo  Veterinary  Medicine. 

under  a  hot  sun  and  with  no  breeze  suffer  extensivel_v  from  in- 
solation, the  temperature  of  their  bodies  rising  to  iro°  to  112° 
Fah.  and  even  higher.  Cold  is  equally  potent.  With  a  temper- 
ature below  zero  Fah.,  the  iron  bit  will  freeze  the  baccal  mucous 
membrane,  and  cause  extensive  erosion  of  the  mouth.  The  cold 
of  salted  snow  or  ice  will  freeze  the  feet,  causing  sloughing  of  the 
skin  above  and  around  the  coronet  and  shedding  of  the  hoofs,  and 
predisposing  to  fatal  septic  infection  of  the  wounds.  On  the  system 
at  large,  cold  causes  retrocession  of  the  blood  upon  the  internal 
organs,  and  endangers  the  occurrence  of  acute  disease  in  any 
structure  which  is  already  debilitated  or  otherwise  susceptible. 
The  nervous  effect  of  the  chilling  of  the  skin  is  often  the  unbal- 
ancing factor  which  sways  the  scale  in  favor  of  disease,  which  the 
system  was  able  to  resist  until  this  disturbing  element  was  intro- 
duced. The  sudden  chill  from  pas.sing  out  of  the  warm  barn  into 
the  frosty  air,  from  plunging  into  icy  water,  from  standing  in  cold 
rain  or  sleet,  from  standing  in  a  draught  of  cold  air  especially 
when  perspiring,  is  a  fruitful  source  of  many  diseases.  In  the 
cow,  lying  with  the  udder  on  a  cold  stone  may  be  the  starting 
point  of  mammitis.  The  effect  of  sudden  chill  is  well  exemplified 
in  the  great  prevalence  of  diseases  of  the  respiratory  organs  at  the 
change  of  the  seasons  in  spring  and  autumn  when  the  vicissitudes 
of  temperature  are  greatest,  and  the  system  unprepared  by  habit, 
to  bear  the  sudden  change.  Again  it  must  be  noted  that  expos- 
ure to  cold  has  a  tendency  to  cause  disintegration  and  .solution  of 
the  red  blood  globules,  and  that  certain  animals  are  especially 
susceptible  to  this  influence.  The  condition  of  the  atmosphere  is 
often  a  direct  cause  of  disease  as  when  charged  with  offensive  or 
irritating  gases,  the  result  of  decomposition  of  organic  matter, 
with  sewer  or  ces.spool  emanations,  with  deleterious  gases  from 
chemical  works,  telluric  sources,  or  fires.  A  low  state  of  health, 
a  local  irritation  in  some  part  of  the  air  passages,  or  even  a  speedy 
asphyxia  may  be  the  outcome  of  such  atmospheric  conditions. 
Again  the  presence  of  solid  particles  of  a  more  or  less  irritant, 
septic  or  infecting  kind  prove  the  .starting  point  of  various 
diseases.  The  stone  cutters'  phthisis,  and  the  sand  granule 
ophthalmia  are  familiar  examples  of  the  irritant,  which  often  acts 
through  the  dust  of  the  highway.  Of  the  infecting  particles  we 
have  the  germs  of  cattle  lung  plague,  of  infective  ophthalmias. 


Etiology  :    Caiiscs  of  Disease.  ii 

and  of  tub2rculosis  carried  with  the  dry  dust  and  inhaled.  Of 
toxic  agents  borne  on  the  atmosphere  we  see  the  compounds  of 
arsenic,  mercurj-  and  lead.  Moisture  and  dr>-ness  of  the  air  in- 
duce respectively  a  lymphatic  constitution  and  low  tone  of  health, 
and  a  nervous  constitution  and  a  tendency  to  neurosis,  ophthalmias, 
and  skin  diseases.  The  pressure  of  the  atmosphere  has  a  pro- 
found effect  on  animal  health  as  seen  in  the  extreme  troubles 
of  the  heart  and  circulation  in  the  diving  bell,  and  the  respirator^*, 
haemorrhagic  and  brain  affections  of  high  attitudes.  A  low  bar- 
ometer is  attended  by  nervous  disorders  (neuralgia)  (S.  Weir 
Mitchell).  Surgical  operations  do  best  with  a  high  or  rising  bar- 
ometer (Adinell,  Hewson).  The  electrical  tension  of  the  atmos- 
phere shows  familiarly,  in  man,  in  the  feeling  of  heaviness,  dull- 
ness and  malaise  that  precedes  the  bursting  of  a  thunderstorm 
and  the  relief  that  follows  its  termination.  To  this  influence 
many  of  the  domestic  animals  are  incomparably  more  sensitive 
than  man,  as  witnessed  in  the  disposition  of  swine  to  hide  in  their 
pens  or  under  litter  on  the  approach  of  the  storm,  the  nervous 
disturbance  even  to  abortion  of  certain  ewes  which  are  heav)-  in 
lamb,  and  the  great  discomfort  and  even  piteous  cries  of  some 
domestic  felines  on  such  occasions.  The  greatest  electric  tension 
is  seen  in  the  drier  climates,  where  the  air,  robbed  of  its  moisture, 
proves  a  poor  conductor  and  equalizer,  and  the  positive  and  nega- 
tive electricity  get  stored  up  separately  in  air,  cloud  and  soil.  The 
presence  of  ozone. in  the  air,  as  a  habitual  concomitant  of  electric 
discharges,  has  been  supposed  to  be  a  disturbing  influence,  since 
it  is  distinctly  irritating  to  the  mucous  membrane  when  present 
in  excess,  but  such  excess  apart  from  its  artificial  production  is 
highl}-  improbable.  As  habitually-  met  with  it  is  antiseptic  and 
health  giving.  Darkness  alwaj's  deteriorates  the  general  health, 
producing  bloodlessness  and  pallor.  Light  is  usualh'  invigorat- 
ing, 3-et  bright  sunshine  falling  upon  the  eyes  from  a  window  in 
front  of  the  stall,  or  in  the  open  air  when  the  face  is  turned  up  by 
an  overdraw  check  rein,  or  reflected  from  white  dust  and,  above 
all,  from  snow,  will  often  induce  inflammation  and  blindness. 
Soils  are  often  potent  etiological  factors.  Dense,  damp,  cold,  un- 
drained  soils,  are  habitually  covered  by  a  stratum  of  cold  air, 
saturated  with  moisture,  which  greatly  lowers  the  vital  stamnia. 
Damp  clays,    and    waterlogged  soils  of   various   kinds,    rich  in 


12  Veterinary  Medicine. 

organic  debris,  are  the  natural  homes  of  various  pathogenic 
microbes,  such  as  those  of  ague,  anthrax,  milk  sickness,  actino- 
mycosis and  yellow  fever.  Well  drained  sandy  or  gravelly  soils 
are  usually  healthy,  unless  they  contain  a  great  excess  of  decom- 
posing organic  matter.  Again  soils  with  an  excess  of  alkaline  cr 
other  mineral  matter  may  prove  deleterious,  and  those  on  the 
magnesian  limestone  often  harbor  the  poison  of  goitre,  and  cretin- 
ism, and  favor  the  occurrence  of  urinary  calculus.  Faulty  food 
and  feeding  in  the  domestic  animals  are  chargeable  with  many 
diseases.  Stock  often  fall  off  in  condition,  in  the  hands  of  one 
feeder,  when  the  same  food  given  with  regularity  and  judgment 
by  a  more  careful  feeder  would  keep  them  in  the  highest  health. 
Hay  and  grain  which  is  musty  and  filled  with  cryptogams  and 
their  products,  are  common  causes  of  disorder  of  the  stomach,  the 
kidneys,  the  nervous  system  or  of  general  nutrition.  Smut  and 
ergot  at  certain  stages  of  their  growth  or  grown  under  given  con- 
ditions cause  nervous  disorders,  abortions,  and  gangrene  of  the 
extremity.  A  long  list  of  vegetable  poisons  may  mix  with 
fodders,  and  animal  poisons  with  the  food  of  the  Carnivora.  A 
number  of  standard  fodders  may  be  poisonous  at  certain  stages  of 
growth,  as  partially  ripened  perennial  rye  grass,  millet,  Hun- 
garian grass,  vetches,  etc.  Water  and  deprivation  of  water  are 
fertile  causes  of  illness.  Ruminants  cannot  chew  the  cud  when 
deprived  of  water,  hence  impaction  of  the  first  and  even  of  the 
third  stomach  with  fermentations,  tympany  and  other  disorders. 
Horses  suffer  more  from  a  full  drink  of  water  after  a  feed  of 
grain,  the  unchanged  albuminoids  being  carried  on  into  the  in- 
testines, and  both  gastric  and  intestinal  indigestion  induced. 
Sheep  suffer  fatal  fermentations  after  drinking  the  alkaline  water 
of  the  Plains  ;  cattle  have  diarrhoea  and  dysentery  from  seleni- 
tions,  or  from  stagnant  and  putrid  water  ;  and  the  water  from  the 
dolomite  is  the  usual  channel  of  the  goitre  poison.  Certain  germs 
like  the  plasmodia  of  malaria,  and  comma  bacillus  have  their 
natural  home  in  impure  water,  and  others  like  anthrax  bacillus 
survive  in  the  mud  and  silt  at  the  bottom  of  wells,  ponds,  and 
rivers  and  enter  the  system  in  the  water.  Compulsory  rest  in  a 
stall  often  induces  torpor  of  liver  and  bowels,  general  muscular 
debility,  and  fatty  degeneration  especiall}^  of  the  liver  and  heart. 
A  few  months  of  the  swill  feed,  hot  atmosphere  and  absolute  rest 


Etiology:    Causes  of  Disease.  13 

in  a  distillery   stable   usually    ruins   cattle   for   stock   purposes. 
Overexertioyi  on  the  other  hand  is  prolific  of  illness.     Exhaustion 
of    the   muscles,    congestion,    inflammation,    cramps,    congested 
lungs,  heart  failure  or  rupture,  apoplexies  and  other  haemorrhages 
are  among  the  resultant  maladies.     Auto-poisoning  is  another  re- 
sult shown  in  equine  hsemoglobingemia,   and  the  fever  of  leuco- 
maines.      The  excessive   development  of   sarcolactic   acid   from 
muscular  work  may  render  an  insusceptible  animal  susceptible  to 
the  anthrax  bacillus.     Mechanical  causes  would  include  overexer- 
tion, in  the  production  of  strains,  fractures,  and  other  injuries. 
They  would  also  include  impaction  by  foreign  bodies,  calculi,  and 
ingesta,  friction  of  folds  of  skin  or  by  harness  and  other  objects 
and  pressure  which  leads  to  absorption  and  atrophy.     To  these 
must  be  added  poisons  of  vegetable,   mineral  and  animal  origin 
and  the  niicrooiganisms  which  act  as  injurious  ferments  within 
the  animal  body.     These  will  be  treated  more  fully  later  on.     Of 
the  microorganisms  it  may  be  said  here,  that  they  are  almost  cer- 
tainly the  cause  of  all  transmissible  diseases.     These  diseases  are 
variously   named   on   the   basis   of   different    ideas.       They    are 
enthetic,  that  is  implanted  as  a  seed  is  planted  in  the  ground  to 
grow  and  multiply.     They  are  zymotic  or  fermentative  because 
the  essential  cause  multiplies  and  is  propagated  like  a  ferment. 
They  are  contagious  because  propagated  by  contact  mediate  or 
intermediate.     They  are  infectious  when  transmitted,  not  alone 
by  contact  but  through  the  atmosphere.     They  are  epizootic  be- 
cause they  tend  to  attack  animals  generally  or  a  given  genus  or 
family  of  animals  generally  when  these  are  exposed  to  the  infec- 
tion.    They  are  enzootic  when  confined  to  the  animals  in  a  given 
locality,  the  soil  or  conditions  of  which  are  favorable  to  the  pres- 
ervation of  the  germ  in  pathogenic  potency,  or  to  the  production 
of  a  special   susceptibility   in    the   animal    system.       They   are 
sporadic  when  each  case  occurs  without  an}'^  casual  relation   to 
another.       They   are   called    panzootic    when   they    attack    all 
animals  without  apparent  preference.     The  term  panzootic  is  also 
used  to  describe  those  recrudescences  of  a   disease  or  cycles  of 
exalted  pathogenesis  which  are  observed  in  contagious  diseases, 
which  frequently  last  for  years  and  again  give  place  to  a  period 
of  benignancy.     Such  cycles,  of  malignancy  and  benignancy,  may 
be  due  to  modified  environment  acting  either  on  the  disease-germ 
or  the  animal  system,  or  on  both  simultaneously. 


14  Veterinary  Medicine. 

The  terms  enthetic,  zymotic,  and  contagious  best  express 
modern  views  of  the  nature  of  these  maladies.  The  terra  infec- 
tious when  used  to  express  a  gaseous  or  otherwise  intangible 
(unorganized)  body,  or  influence  transmitted  through  the  air, 
necessarily  excludes  the  particulate,  living,  self-propogating  germ 
upon  which  the  transmissibility  of  the  disease  depends.  A  chem- 
ical, electrical,  or  other  body  or  influence  generated  outside  the 
animal  body,  cannot  well  be  conceived  of  as  reproducing  itself 
within  the  animal  body  but  must  act  like  any  other  ectogenous  poi- 
son, according  to  the  size  of  the  dose  and  the  frequency  of  its  ex- 
hibition. This  might  create  an  enzootic  disease  but  would  lack  all 
the  qualities  of  a  contagious  affection  since  it  could  not  spread 
from  a  victim  when  taken  elsewhere  and  turned  among  animals 
which  would  prove  equally  susceptible  if  placed  within  the  infect- 
ing area.  Suppose  on  the  other  hand  we  apply  the  term  infectious 
to  diseases  in  which  the  levity  of  the  particulate  living  germ  al- 
lows of  its  being  inhaled  into  the  body  of  the  susceptible  animal, 
the  case  becomes  one  of  simple  mediate  contagion,  the  air  acting 
as  the  intermediate  bearer. 

The  term  zymotic  conveys  a  clear  idea  of  the  method  of  in- 
crease of  the  disease  germ  in  the  body  by  the  ordinary  process  of 
generation.  The  old  doctrine  of  fermentation  by  a  continuous 
change,  due  to  contact  with  dead  fermenting  matter,  as  an  inflam- 
mable body  continues  to  burn  by  contact  with  the  incandescent 
portion,  has  been  definitely  disproved  by  the  investigations  of 
Pasteur  and  others,  and  today  we  must  recognize  that  every  fer- 
mentation is  the  result  of  the  propogation  and  vital  activity  of 
living  organisms.  This  does  not  ignore  that  the  chemical  prod- 
ucts or  enzymes  which  are  constructed  by  the  vital  activity  of  the 
microbes,  will  dissolve  or  transform  organic  matter,  but  in  the 
absence  of  the  microbe  no  such  enzyme  can  reproduce  nor  mul- 
tiply itself  and  its  action  must  therefore  be  exactly  limited  by  its 
amount.  The  living  germ  itself  is  therefore  the  one  effective  fac- 
tor, by  which  the  contagious  disease  may  be  maintained  and 
propagated.  In  its  turn  the  living  germ  can  only  come  from  a 
pre-existing  living  germ.  To  the  scientist  of  today  the  doctrine 
of  spontaneous  generation  is  a  thing  of  the  past  and  the  aphorism 
omnis  ovum  ex  ovo  is  dominant.  The  argument  drawn  from  the 
saccharizing  of  starch  in  the  germinating  seed  by  the  operation  of 


Etiology  :    Causes  of  Disease. 


15 


diastase  is  inapplicable,  as  the  diastase  is  produced  by  the  living 
cells  of  the  germinal  part  of  the  seed,  which  are  thus  the  coun- 
terpart of  the  disease  germ.  No  such  glycogenic  action  occurs  in 
the  seed  that  has  been  boiled  or  otherwise  robbed  of  its  vitality. 
So  with  the  arguments  drawn  from  the  ptyaline  of  the  saliva,  the 
pepsin  of  the  gastric  juice,  and  the  tr3^psin  of  the  pancreatic 
juice  ;  each  of  these  is  the  product  of  the  living  cells  of  the  gland 
by  which  it  is  secreted,  and  cannot  increase  its  own  substance  in 
the  absence  of  these  cells.  Like  the  enzyme  of  the  bacteridian 
ferment,  these  gland  products  can  break  down  or  digest  certain 
organic  matters,  but  in  all  alike,  the  only  source  of  the  chemical 
solvent  is  the  living  bacterium  or  gland  cell  from  which  the  par- 
ticular product  is  derived.  The  toxins  of  a  virulent  liquid,  after 
the  sterilization  of  the  latter  may  still  produce  most  of  tli2  lesions 
and  morbid  phenomena  of  the  disease,  but,  although  death  were 
to  ensue,  the  body  of  the  victim  would  not  be  infecting  to  other 
susceptible  animals.  The  parallel  between  the  funitions  of  the 
secreting  animal  cells  and  the  disease  germs  may  thus  be  put  in 
tabular  form  : 

Living  Source.  Chemical  Product, 

Salivary  gland  cells     =    Ptyaline 


Result. 
=  Starch    changed    to 

Sugar. 
=  Albuminoids  chang- 
ed   to    peptones    in 
acid  solutions. 
=  Albuminoids  chang- 
ed   to    peptones    in 
alkaline  solutions. 
Toxin:  Enzyme  =  Morbid  phenomena. 
Contagious  disease. 
Further  consideration  of    pathogenic  microorganisms  will  be 
found  in  connection  with  contagious  diseases. 


Peptic  gland  cells         =     Pepsin 


Pancreatic  gland  cells  =     Trypsin 


Disease  germ 
Disease  germ 


MEDICAI.   DIAGNOSIS. 

Means  of  diagnosis.  Usual  health  of  the  subject.  History  of  the  attack. 
Objective  symptoms,  interdependent  disease,  fever,  diseases  that  may  be 
confounded,  subsidiary  disease,  diagnostic  signs,  organ  involved,  patholog- 
ical test  injections,  course  of  disease,  sporadic  or  zymotic,  result  of  treat- 
ment. 

Diagnosis  is  the  determination  of  the  seat  and  nature  of  a  given 
di.sease  and  its  distinction  from  other  morbid  conditions.  Its  im- 
portance to  the  practitioner  cannot  be  overestimated  as  it  occu- 
pies the  piv^otal  position  between  causes,  nature,  morbid  phenom- 
ena, and  symptoms  on  the  one  hand,  and  prognosis,  prevention, 
and  treatment  on  the  other.  Unless  the  conclusions  are  sound  as 
to  causes,  nature,  lesions,  and  symptoms,  there  can  be  no  certain 
diagnosis,  and  without  a  correct  diagnosis,  prognosis,  prevention, 
and  treatment  can  have  no  intelligent  or  vScientific  basis.  The 
practitioner  who  finds  a  dropsical  condition  and  who  is  satisfied  to 
pronounce  it  drop.sy  and  institute  treatment  is  abusing  his  trust. 
He  must  find  whether  this  drop.sy  results  from  disease  of  the  kid- 
neys, heart,  blood-vesssls,  lymphatics,  liver,  lungs,  bowels,  or  the 
structures  in  which  it  is  shown  ;  whether  it  is  due  to  parasites  or 
imperfect  sanguification  or  to  other  morbid  conditions,  before  he 
dare  prescribe  treatment  and  predict  results.  So  in  every  other 
affection  ;  the  failure  to  make  a  correct  diagnosis  opens  to  the 
practitioner  many  doors  of  error,  and  he  is  happy  indeed  if  he 
can  escape  the  injuring  of  his  patient. 

In  seeking  a  sound  diagnosis  we  must  attend  to  the  following 
among  other  indications  : 

ist.  The  habitual  state  of  health  of  the  subject.  The  genus, 
breed,  age,  environment,  habits,  (pet  dog,  watch  dog,  hound, 
sheep-dog,  ox,  bull,  cow,  milch  cow,  sheep  in  the  field  or 
housed,  pig  in  pen  or  at  large,  diet,  regimen,  water,  race  horse, 
draught  horse,  work,  exposure,  etc.)  as  well  as  the  personal 
equation  of  temperament,  idiosyncrasy,  heredity,  etc.,  must  all 
be  carefully  con.sidered. 

2d.  The  history  of  the  present  illness  as  to  its  apparent  cause, 
mode  of  invasion,  duration  and  progress. 

3d.  The  objective  symptoms  by  which  it  is  manifested.  All 
that  can  be  ascertained  in  the  way  of  symptomatology,  local  and 


Medical  Diagnosis.  17 

general,  the  probable  existence  of  interdependent  disease,  and  all 
actual  structural  lesions  and  disorders  of  function  should  be 
thoroughly  investigated.  As  supplementary  to  the  more  promi- 
nent objective  symptoms  any  fever  or  other  constitutional  disorder 
must  be  sought  for  ;  a  mental  list  must  be  made  of  the  diseases 
which  resemble  this  one,  and  these  must  be  excluded  one  by  one 
by  careful  attention  to  the  differential  symptoms  ;  other  diseases 
which  are  probably  subsidiary  to  this,  should  be  similarly,  investi- 
gated and  excluded  ;  any  really  diagnostic  sign  of  the  suspected 
disease  must  be  carefully  established  and  the  diagnosis  finally 
placed  on  a  solid  foundation.  The  di.scovery  of  a  constitutional 
(febrile)  disease  to  which  a  distinctive  name  can  be  given  is  by 
no  means  the  end  of  the  diagnosis  ;  the  structural  lesions  of  the 
disease  may  be  largely  localized  in  an  unimportant  organ  where 
they  may  remain  circumscribed  without  compromising  life,  or 
they  may  be  seated  in  a  vital  organ  which  will  render  the  disease 
grave  to  the  last  degree  or  necessarily  fatal.  For  example  :  An- 
thrax of  a  den.se,  dr}^  part  of  the  skin  may  be  a  mild  local  disease  ; 
anthrax  of  an  internal  organ  is  usually  fatal.  Kvery  local  com- 
plication therefore,  should  be  as  carefully  diagnosed  as  the  con- 
nected constitutional  disorder. 

But  diagno.sis  cannot  always  be  certain.  In  the  early  stages 
of  certain  fevers  two  forms  may  be  as  yet  indistinguishable  and  a 
day  or  two  may  be  required  to  develop  differential  .symptoms.  In 
some  occult  forms  of  disease  all  differential  symptoms  may  fail 
us.  A  method  of  diagnosis  which  has  hitherto  been  applied  only 
to  tuberculosis  and  glanders  is  manifestly  capable  of  much  wider 
application,  to  diseases  attended  with  a  febrile  reaction.  This 
consists  in  a  hypodermic  injection  of  a  minimum  dose  of  the  ster- 
ilized and  filtered  products  of  the  culture  of  the  disease  germ, 
which  produces  no  effect  on  the  healthy  .system  but  causes  febrile 
reaction  or  local  inflammation,  or  both,  in  the  diseased.  This  will 
be  treated  more  fully  under  the  respective  diseases. 

In  connection  with  such  a  method,  but  above  all  when  no  such 
resort  has  been  had,  the  ob.scure  case  should  be  seen  frequently, 
the  course,  duration,  and  termination  of  the  disease  should  be 
noted,  also  its  tendency — sporadic  or  epizootic,  and  finally  the  re- 
.sult  of  treatment.  This  last  resort  may  often  secure  diagnosis 
and  cure  at  once  as  when  a  course  of  iodine  cures  an  obscure  ac- 
tinomycosis. 
2 


SYMPTOMATOLOGY.     SEMEIOLOGY. 

Definition.  Symptom.  vSigii.  Constitutional  symptoms— local,  object- 
ive, subjective,  direct  —  idiopathic,  indirect  —  symptomatic,  premonitory. 
Anamnesis.  Position.  Movements.  Decubitus.  Acute.  Chronic.  Fe- 
ver. Sthenic.  Asthenic.  State  of  limbs,  muzzle,  nose,  snout,  palmar- 
pad,  hoof,  bill,  digits,  mouth.  Thermometry.  Normal  temperature,  in 
doors,  in  field,  at  work,  in  hot  season,  in  nervous  subject,  in  thirst,  in 
youth — age,  starvation,  plethora,  cold,  sleep,  rest,  stimulants,  suppressed 
perspiration,  eliminants,  antipyretics.  Fever  temperature,  morning,  even- 
ing, transient  elevation,  persistent  rise,  sudden  fall — collapse,  crisis.  Fatal 
elevation.  Rise  during  defervescence.  Pulse.  Respiration.  Skin,  star- 
ing coat,  pallor,  coldness,  dryness,  harshness,  mellowness,  pliancy,  hide- 
bound, yolk,  clapped  wool,  scurfy,  lesions,  itchiness,  tenderness,  loss  of 
hair,  emphysema,  anasarca,  sweat,  sebum.  Expression,  life,  dullness, 
paralysis,  dropsy,  jaundiced,  eye,  discolorations,  photophobia,  amaurosis, 
pinched  face.  Nasal  mucosa,  red,  violet,  etc.,  nodules,  polypi,  osseous  dis- 
ease, pentastoma,  oestrus,  discharge  from  teeth — sinuses — actimomycosis — 
tumors.     State  of  the  bowels,  kidneys,  nervous  system. 

The  usual  basis  of  diagnosis  must  be  a  clear  and  intelligent 
observation  of  the  symptoms  of  disease.  A  symptom  is  an  ap- 
preciable evidence  of  disease.  A  symptom  however  may  indicate 
illne-ss,  without  affording  the  means  of  diagnosis,  while  the  term 
sign  is  often  used  for  a  pathognomonic  symptom — one  by  which 
the  disease  can  be  identified.  Used  in  this  sense  a  sign  may  be 
said  to  be  a  diagnostic  symptom. 

1.  Constitutional  Symptoms  are  such  as  affect  the  entire 
system,  like  a  rise  of  body  temperature,  or  a  shivering  fit. 

2.  Local  Symptoms  are  confined  to  a  definite  area  as  red- 
ness, tenderness,  .swelling,  ulceration. 

3.  Objective  Symptoms  incltide  all  that  can  be  recognized 
by  the  senses  of  the  observer.  These  alone  are  available  in  deal- 
ing with  the  lower  animals. 

4.  Subjective  Symptoms  can  only  be  felt  by  the  patient 
himself,  as  pain,  giddiness,  cold,  heat,  blindness,  numbness. 
Such  symptoms  are  therefore  only  obtainable  from  the  human 
patient  who  can  tell  how  he  feels.  In  the  lower  animals  they 
can  only  be  matter  of  inference,  thus  pain  may  be  inferred  from 
lameness  or  wincing  on  pressure,  and  giddiness  from  unsteady 


Symptomatology .     Semeiology.  19 

gait.  Tli2  fact  that  the  veterinarian  is  restricted  to  objective 
symptoms  renders  his  task  a  specially  difficult  one,  yet  this  has  its 
compensation,  as  this  very  restriction  tends  to  train  the  observant 
practitioner  to  greater  skill. 

5.  Direct  Symptoms  (idiopathic)  are  those  which  are  con- 
nected with  the  seat  of  disease,  as  the  redness,  exudation,  and 
swelling  of  inflammation. 

6.  Indirect  (sympathetic,  dependent)  Symptoms  are  ob- 
servable at  a  distance  from  the  actual  disease  : — as  when  headache 
attends  on  dyspepsia,  or  lameness  in  the  right  shoulder  upon  dis- 
ease of  the  liver. 

7.  Premonitory  or  precursory  symptoms  precede  the  diag- 
nostic symptoms  of  some  diseases,  thus  dullness  and  languor 
often  heralds  an  approaching  fever,  and  the  strangles  of  young 
horses  is  often  preceded  by  a  general  unthrifty  appearance,  poor 
appetite  and  indisposition  to  exertion. 

In  observing  symptoms  as  in  other  things,  some  have  far  greater 
natural  ability  than  others,  but  in  all  a  careful  training  will  do 
much  to  develop  and  improve  the  power  and  habit.  A  most  im- 
portant thing  in  such  habits  is  the  strict  maintenance  of  a  system, 
not  to  be  followed  as  a  cast  iron  rule  but  to  be  constantly  kept  in 
mind  and  .strictly  carried  out  except  when  sound  judgement  and 
experience  show  it  to  be  unnecessary. 

Anamnesis.  As  a  rule  the  first  thing  to  be  learned  about  a 
patient  is  his  history,  and  personal  and  hereditary  characteristics. 
What  are  his  general  health,  temperament,  previous  attacks, 
hereditary  predisposition,  environment  ?  Is  the  site  of  the  build- 
ing, its  condition  as  regards  soil,  springs,  drainage,  structure, 
ventilation,  light,  cleanliness  such  as  would  favor  any  particular 
disorder  or  class  of  disorder?  Is  the  patient  in  high,  low,  or 
moderate  condition,  robust  or  debilitated,  alert  and  lively  or  dull 
and  stupid  ?  Have  other  animals  suffered  recently,  or  at  a  cor- 
responding season,  or  under  similar  conditions  in  apparently  the 
same  manner?  How  long  has  the  patient  suffered,  were  there 
any  premonitory  indications  of  illness,  what  were  the  first  symp- 
toms, and  what  symptoms  have  followed  up  to  the  present  ? 
Has  there  been  any  change  of  food,  water  or  management  that 
might  throw  light  on  the  cause  ?  Has  there  been  any  change  of 
weather  or  unwonted  exposure  to  cold,   storm,   overwork,   com- 


20  Veteriyiary  Medicine. 

pulsory  abstinence  or  enforced  retention  of  some  secretion  ?     If 
a  female  is  she  pregnant  ? 

Having  exhausted  this  method,  using  such  Hues  of  inquiry  as 
promise  good  results  in  the  particular  case,  the  veterinarian  is 
prepared  to  bring  his  own  powers  of  observation  to  bear  more 
directly. 

Position  and  movements  will  often  furnish  valuable  data. 
The  horse  which  lies  on  his  ribs,  stands  obstinately  in  chest 
diseases,  or  whenever  there  is  much  interference  with  breathing. 
The  ruminants  and  carnivora  on  the  other  hand  which  lie  on 
their  smooth  or  padded  sternum,  can  breath  with  comfort  in  this 
position  and  only  stand  up  persistently  in  the  worst  cases.  The 
habit  of  .standing  day  and  night  is  also  characteristic  of  anchylosed 
back  or  loins  in  the  solipede.  Roached  back  may  be  natural,  or 
the  result  of  overwork  and  slight  sprains  or  injuries  of  the  loins, 
of  anchylosis,  of  intestinal  or  renal  inflammation,  or  of  certain 
injuries  to  the  limbs.  The  extension  of  the  head  on  the  neck 
may  suggest  sore  throat,  chest  disea.se,  tumors  around  the  throat, 
abscess  (fistula)  of  the  pole,  sprain  or  .spasm  of  the  extensors  of 
the  neck,  disease  of  the  axoido-atloid  joint,  tetamus,  or  cervical 
rheumati.sm.  Dropping  of  head  and  neck  might  suggest  paresis, 
mechanical  injury  to  the  levator  muscles  or  cervical  ligament,  ex- 
treme debility,  or  prostration  from  a  profoundly  depressing  fever  or 
poisoning.  Inability  or  indisposition  to  back,  might  indicate 
sprain  or  fracture  of  the  back,  anchylosis,  laceration  of  the  sub- 
lumbar  muscles,  paresis,  cerebral  or  spinal  inflammation,  soften- 
ing or  other  lesion,  tetanus,  laminitis,  dislocated  patella  and 
certain  other  affections.  Swaying  or  unsteadiness  in  walking 
or  turning  would  similarly  .suggest  .sprain  or  fracture  of  the  back, 
paresis  and  other  nervous  and  locomotor  injuries.  The  soli- 
pede with  peritonitis  arches  the  back  and  draws  the  hind  feet 
forward  under  the  belly,  with  impacted  colon  or  obstruction  to 
urination  he  will  often  stretch  with  fore  limbs  advanced  and 
hiud  limbs  retracted.  The  mode  of  decubitus  may  be  significant. 
With  peritonitis,  enteritis,  metritis  or  acute  nephritis  or  hepatitis 
the  solipede  lies  down  slowly  and  with  caution  :  with  spasmodic 
colic  he  throws  him.self  down  as  if  reckless  of  possible  injury. 
Lying  well  up  on  the  costal  cartilages  and  .side  of  the  breast  bone 
suggests  a  slight  affection  of  the  air  passages  ;  lying  on  the  side, 


Symptomatology .     Semeiology .  2 1 

disease  of  other  parts.  Rolling  on  the  back  may  indicate  simple 
intestinal  spasm,  but  also  blocking  by  intususception,  impaction, 
volvulus  or  otherwise.  Sitting  on  the  haunches  may  suggest  a 
similar  trouble  or  it  may  imply  ruptured  stomach  or  diaphragm. 
The  dog  may  sit  on  his  haunches  in  health,  or  with  dyspnoea  in 
acute  affections  of  the  respiratory  organs,  asthma  and  heart  af- 
fections. Decubitus  on  the  belly  with  hind  legs  extended  back- 
ward, may  imply  paraplegia,  or  acute  inflammation  of  the  abdom- 
inal organs.  Lying  with  the  nose  in  the  flank  or  turning  the 
head  toward  the  flank,  though  a  normal  position  of  rest,  often  in- 
dicates abdominal  suflfering.  Turning  of  the  head  to  one  side 
may,  however,  suggest  injury,  spasm  or  rheumatism  of  the  cer- 
vical muscles,  or  disease  on  the  corresponding  side  of  the  brain. 
Animals,  at  liberty,  lie  more  frequently  on  the  side  on  which  the 
heaviest  internal  organs  are  lodged,  thus  ruminants,  pigs,  and 
dogs  rest  on  the  right  (the  side  of  the  liver)  though  in  cattle  with 
1  heavily  loaded  rumen  the  condition  may  be  reversed.  Decub- 
itus on  the  abdomen,  with  the  limbs  extended  and  abducted  im- 
plies profound  nervous  disorder  or  shock. 

Habitual  decubitus  often  indicates  severe  suffering  in  legs  or 
feet.  Resting  one  limb  more  than  another  implies  injury  to  that 
limb.  Standing  with  the  pastern  of  one  limb  more  upright  than 
the  others  has  the  same  meaning.  Extension  of  one  fore  foot  in 
advance  of  its  fellow  with  flexion  of  the  pastern  and  fetlock  de- 
notes suffering  in  the  posterior  part  of  the  foot  or  in  the  flexors. 
Flexion  of  carpus  and  fetlock  without  advance  of  the  foot  prob- 
ably bespeaks  injury  to  shoulder  or  elbow.  Inabilit}^  to  bear 
weight  on  the  fore  limb,  without  knuckling  at  the  knee,  should 
call  for  examination  of  the  olecranon  and  joints  especially  the 
elbow.  Inability  to  extend  the  carpus  should  lead  to  investiga- 
tion of  the  flexor  muscles  and  tendons,  the  joints  and  the  heel. 
Movement  of  the  hind  limb  without  flexure  of  the  tarsus  would 
suggest  injury  to  that  joint,  the  stifle  or  the  flexor  metatarsi 
tendon.  Inability  to  extend  stifle  and  hock,  should  demand  ex- 
amination of  the  tendo-Achillus  and  olecranon,  of  the  triceps  ex- 
tensor cruris  and  of  its  nerves. 

Atrophy  of  a  muscle  or  group  would  require  scrutiny  of  its 
tendons  and  its  nerve  and  blood  supply. 

INIore  precise  indications  of  injury  of  the  locomotor  system  must, 
be  found  under  surgery. 


22  Veterinary  Medicine. 

After  posture,  the  general  or  constitutional  disorder  may  claim. 
attention.  Is  the  illness  acute  or  chronic?  Is  fever  present? 
Has  the  animal  had  a  rigor?  Does  the  coat  stare  in  patches 
(along  the  spine)  or  generally  ?  Is  there  perspiration  ?  Is  there 
full,  clear,  somewhat  congested  eye  (sthenic)  or  drooping  lids 
over  a  dull  brownish  sclerotic  (asthenic).  Are  the  lower  parts  of 
the  limbs  and  other  extremities  cold,  and  the  roots  of  the  horns 
or  ears  hot  ?  Is  there  significant  heat  and  dryness  of  the  muzzle 
(ox),  nose  (dog),  snout  (pig),  palmar-pad  (carnivora),  hoof 
(solidungala,  bisulcates),  bill  and  digits  (birds)  ?  Has  the  mouth 
the  hot  burning  feeling  of  fever  ?  Finally  is  the  temperature  as 
indicated  by  the  thermometer  abnormally  high  ?  To  estimate  this 
with  any  degree  of  certainty  one  must  be  well  acquainted  with  the 
normal  temperature. 

Normal  temperature.  As  taken  indoors  under  ordinary  con- 
ditions, the  normal  temperature  taken  in  the  rectum  may  be  : 
fowl,  107° — 110°  F.  ;  swine,  103°— 106°  F.  ;  goat  and  sheep,  103° 
— 104°  F.  ;  ox,  ioo°— 102°  F.  ;  dog,  99°— 100°  F.  ;  horse,  99°— 
99.6°  F.  Ranging  in  the  fields,  at  work,  or  on  forcing  or  stimu- 
lating feeding,  it  may  be  1°  higher  than  when  at  rest  indoors.  A 
whole  herd  may  be  raised  2°  by  a  three  miles  drive  in  warm 
weather.  In  our  summer  heats  a  rise  of  1°  is  common.  In  ner- 
vous animals  any  change  in  management  ma}^  raise  the  tempera- 
ture, for  example,  1°  to  2°  after  failure  to  water  at  the  usual  time, 
or  from  retaining  the  milk  in  the  udder  when  the  milker  had  been 
changed.  Young  animals  are  normally  .5°  to  i°  warmer  than  old 
ones  though  more  sensitive  to  the  action  of  cold.  Half  starved 
animals,  when  put  on  abundant  and  nutritious  food  may  have  a 
rise  of  1°  or  more.  Females  in  heat,  in  advanced  pregnancy  and 
at  the  time  of  parturition  are  usually  1°  to  3°  above  the  natural 
temperature.  Among  the  agencies  lowering,  temperature  are  : 
cold,  (1°  to  2°)  ;  sleep,  (1°  to  2°)  ;  rest  ;  starvation  ;  alcoholic 
and  other  circulatory  stimulants  which  fill  the  cutaneous  capillaries 
and  thereby  cool  the  whole  mass  of  blood  ;  suppression  of  insen- 
sible perspiration  (retention  of  waste  matters)  as  by  varnishing 
the  skin  which  lowers  the  temperature  to  25°  ;  purgatives  and  di- 
uretics (1°)  ;  certain  drugs  like  antipyrin,  acetanilid,  etc.,  which 
act  on  the  heat  producing  centres  and  retard  metabolic  changes. 

Temperature  in  disease.     Comparative  temperatures  should 


Symptomatology .     Semeiology .  23 

be  taken  at  the  same  hours  on  successive  days,  bearing  in  mind 
that  the  morning  temperature  is  usually  slightly  lower  and  the 
evening  one  slightly  higher.  Where  possible  both  morning  and 
evening  temperature  should  be  taken.  With  elevated  tempera- 
ture, repeat  sooner  to  see  that  it  is  not  transient.  A  transient 
rise  of  1°  to  2°  is  unimportant.  A  permanent  rise  of  2°  or  3°  in- 
dicates fever.  A  sudden  additional  ris^  of  several  degrees  in  the 
progress  of  fever  is  grave.  A  persistence  of  the  high  evening 
temperature  to  morning  shows  aggravation.  A  persistence  of 
the  low  morning  temperature  to  the  evening  bespeaks  improve- 
ment. A  sudden  extreme  fall  to  much  below  the  normal  (4°  or 
5°)  indicates  collapse.  This  is  usuall}'  attended  with  other  symp- 
toms of  extreme  prostration  and  sinking.  A  sudden  considerable 
fall  to  near  the  normal,  without  untoward  attendant  symptoms, 
may  indicate  a  crisis  and  a  more  or  less  speedy  improvement  may 
be  hoped  for.  This  sudden  fall  often  attends  the  period  of  erup- 
tion of  certain  exanthemata,  as  cowpox,  horsepox,  sheeppox, 
aphthous  epizootic,  etc.  A  sudden  extensive  fall  of  temperature 
may  result  from  some  transient  accidental  cause,  as  a  prolonged 
deep  sleep,  a  hemorrhage,  the  relief  of  constipation,  or  of  enuresis. 
A  sudden  ri.se  may  supervene  on  such  suppressed  function  or 
other  cause  of  nervous  irritation  or  on  toxin  poisoning,  but  it  does 
not  persist  more  than  twelve  or  twenty-four  hours  after  the  cessa- 
tion of  the  morbific  cause. 

A  rise  of  10°  or  12°  above  the  normal  standard  is  usually 
promptly  fatal. 

A  continued  high  temperature  indicates  persistent  disease,  and 
a  considerable  rise  during  defervescence  implies  a  relapse  and  in 
the  absence  of  any  error  in  diet  or  nursing  is  grave. 

Pulse.  Before  the  introduction  of  the  clinical  thermometer, 
the  indications  furnished  by  the  pulse  were  held  to  be  of  the  high- 
est value.  Though  largely  superseded  by  the  usually  more  re- 
liable thermometer,  yet  they  should  not  be  discarded,  but  em- 
ployed as  symptoms  corroborative  of  the  thermometric  indications. 
In  many  cases  the  pulse  will  furnish  criteria,  when  in  the  absence 
of  fever,  the  heat  of  the  body  will  tell  of  nothing  amiss.  This  is 
especially  true  of  diseases  of  the  heart,  the  large  blood  vessels, 
and  of  the  nervous  sj-stem,  and  in  cases  of  poisoning.  For  special 
indications  furnished  bv  the  pulse,  see  disea.ses  of  the  heart. 


24  Vetef'inary  Medicine. 

Respirations.  The  morbid  activity  or  inactivity  of  the  respi- 
ration, its  modified  rythm,  the  pathological  significance  of  the  al- 
tered breathing  sounds  and  of  the  superadded  sounds,  the  indica- 
tions furnished  by  percussion,  palpation,  mensuration,  succussion, 
sneezing,  snorting,  yawning,  cough,  moan,  grunt,  stertor,  dis- 
charge, etc.,  afford  material  of  inestimable  value  to  the  diagnosti- 
cian.    See  under  diseases  of  the  chest. 

Skin  Symptoms.  The  erection  of  the  liair  of  carnivora  in 
rage  or  fear  implies  a  profound  nervous  disturbance,  and  a  simi- 
lar erection  (staring  coat)  in  the  larger  herbivora  especially,  im- 
plies a  corresponding  nervous  disorder,  due  however  to  a  different 
cause.  The  pallor  and  coldness  of  (white)  skin  and  extremities 
the  retrocession  of  blood  toward  the  internal  organs,  the  contrac- 
tion of  the  involuntary  muscles  of  the  hair  bulbs,  the  sense  of 
cold,  and  the  actual  shivering  all  come  from  the  fundamental 
nervous  disorder.  The  loss  of  lustre  and  gloss  in  the  hair  and 
the  dryness,  rigidity  and  mobility  (mellowness)  of  the  skin  im- 
ply lack  of  nutrition.  The  mellow  feeling  of  the  skin  under  the 
pressure  of  the  finger,  soft  and  yielding  by  reason  of  the  lax 
connection  tissue  and  fatty  layer  in  the  thrifty  animal,  is  in 
marked  contrast  with  the  dry,  hard,  tough,  unyielding  hide 
firmly  adherent  to  the  parts  beneath  (hidebound),  which  denotes 
the  unhealthy  or  unthrifty  animal,  or  from  the  thin,  attenuated, 
mobile,  bloodless  skin  of  the  debilitated  subject,  the  victim  of 
lung,  liver,  or  intestinal  worms.  In  sheep  in  parallel  conditions 
there  is  a  lack  of  yolk  in  the  wool,  which  is  dry,  lustreless  and 
brittle  and  often  flattened  (clapped)  on  the  skin.  In  fowls  ruf- 
fling of  the  plumage  indicates  the  nervous  disorder  and  chill. 
The  skin  may  be  scurfy  in  conditions  of  low  health  or  in  con- 
nection with  the  presence  of  vegetable  or  animal  parasites.  Ring- 
worm has  excessive  scurf,  and  tends  usually  to  a  circular  form, 
and  to  complete  shedding  of  the  hair  from  the  spots.  The  hairs 
split  up  before  dropping.  In  acariasis  there  may  be  scurf,  scab, 
abrasion  and  sore  of  many  kinds,  but  the  outline  is  not  neces- 
sarily circular,  nor  strictly  limited,  isolated  hairs  remain  even  on 
the  bare  patches,  and  itching  is  extreme  as  shown  by  the  move- 
ment of  the  body  and  especially  of  the  lips  or  foot  when  the  part 
is  scratched. 

The  hair  may  be  freely  shed  during  convalescence  from  debili- 
tating diseases,  a  condition  that  must  not  be  confounded  with 


Symptomatology.     Semeiology .  25 

the  yearh'  shedding  of  the  winter  coat  and  the  moulting  of  birds, 
which  is  a  perfectly  normal  process.  Yet  even  the  spring  shed- 
ding and  the  growth  of  the  new  coat  makes  a  great  drain  on  the 
system,  and  must  always  be  taken  into  account  as  a  probable 
cause  of  derangement  of  health. 

The  lesions  of  the  skin  in  the  different  cutaneous  affections 
must  be  remanded  to  the  special  chapter  on  skin  diseases.  The 
following  however  may  be  named  as  having  a  general  bearing. 

Emphysema  may  be  due  to  a  local  wound,  (elbow,  trachea, 
rib);  it  may  indicate  black  quarter,  or  it  may  occur  sub-cutane- 
ously  in  cattle  without  marked  impairment  of  health. 

Anasarca,  from  diseased  blood,  heart,  liver  or  kidneys  is  de- 
noted by  swellings,  often  painless,  or  a  general  infiltration  which 
pits  on  pressure.  It  often  shows  primarily  in  the  lower  parts  of 
the  hind  limbs.  Warty  looking  elevations  must  be  carefully  dis- 
criminated, having  in  mind  primarily  papilloma,  tubercle 
(grapes),  actinomycosis,  condyloma  (in  dogs),  cancer,  melanosis. 
The  secretions  of  the  skin  (sweat,  sebum)  may  be  suppressed, 
or  in  excess,  producing  at  times  a  special  odor,  as  in  thrush  and 
canker  of  the  horse,  cowpox  and  sheep-pox,  and  rheumatism. 
Before  death  the  cadaveric  odor  may  be  marked,  and  attracts 
crowds  of  flies  to  the  victim. 

Fades.  The  countenance  may  be  expressive.  Between  the 
bright,  full,  clear,  prominent  eye  of  health,  and  the  dull,  sunken, 
lifeless,  semiclosed  eye  of  serious  disease  the  contrast  is  extreme. 
The  drooping  lids  (ptosis)  may  be  paralytic  and  even  unilateral, 
in  which  case  drooping  ear,  and  flaccid  lips  and  alse  nasi  com- 
plete the  picture.  With  paralyzed  lips  there  is  usually  drivelling 
of  saliva,  and  dropping  of  half  chewed  morsels  in  the  manger 
and  stall.  The  eye  may  show  dropsical  lids  in  kidney  or  liver 
disease  and  in  anaemic  conditions  like  distomatosis  in  sheep.  It 
may  show  the  upper  lid  b^nt  at  an  angle  in  recurrent  ophthalmia 
of  solipedes.  The  mucosa  may  be  red  in  ophthalmia,  yellow  in 
jaundice,  dusk}-  brown  in  Southern  cattle  fever,  anthrax,  cere- 
bral meningitis,  and  other  fevers  attended  with  destruction  of  red 
globules  and  liberation  of  their  hsematin.  The  pupils  may  be 
all  but  closed  in  internal  ophthalmias,  or  widely  dilated  and  ir- 
responsive to  light  in  amaurosis.  The  iris  may  lack  its  normal 
lustre  or  may  be  distorted  or  torn  in  various  ways  from  adhesions. 
Opacities  of  the  cornea,  lens,  or  vitreous  may  be  recognized. 


26  Veterinary  Medicine. 

The  facial  muscles  may  be  flaccid  and  devoid  of  expression  in 
palsy,  and  prostrating  diseases  ;  they  may  be  firm,  giving  the 
bright,  intelligent  look  of  health  ;  or  they  may  be  painfully 
drawn  in  the  agonized  expression  of  spasmodic  colic  or  enteritis. 

Nasal  Mucosa.  The  pituita  is  bright  red  in  sthenic  fevers, 
simple  acute  coryza,  strangles,  laryngitis  and  inflammation  of  the 
larger  bronchia.  It  assumes  a  violet  hue  in  capillary  bronchitis, 
pulmonary  congestion,  glanders,  and  petechial  fever.  Petechise 
appear  in  the  last  named  affection,  and  in  a  number  of  bacteridian 
diseases,  such  as  anthrax,  swine  plague,  hog-cholera,  the  red 
fever  of  swine  etc.  ;  a  yellow  tinge  in  shown  in  jaundice.  Millet 
like  or  pealike  nodules,  or  elevated  patches,  and  ulcers  show  in 
glanders  and  may  be  felt  by  the  fingers.  In  cattle  hard  millet- 
like nodules  appear  in  a  chronic  coryza  with  hypertrophy  of  the 
mucosa.  The  orifice  of  the  lacliry mo-nasal  duct,  seen  in  the 
horse  on  the  floor  of  the  chamber  at  the  friction  of  the  mucosa 
with  the  skin  of  the  false  no.stril  and  in  ass  and  mule  on  the 
outer  ala  near  the  upper  commissure,  is  sometimes  plugged  with 
inspissated  mucus.  Among  other  lesions  of  the  nasal  chamber 
may  be  named  polypi — soft  and  calcareous, — thickening  and  ob- 
struction in  purpura  hsemorrhagica,  osteoporosis  and  hypertrophy 
of  bone,  and  parasites — pentastoma  denticulata  (in  the  horse  and 
dog),  and  the  larva  of  the  oestrus  (in  .sheep  and  buffalo).  Dis- 
ease of  the  upper  molars  and  abscess  of  the  fronto-maxillary  sinus 
may  be  manifested  by  swelling  beneath  and  on  the  inner  side  of 
the  eye,  foetid  discharge  from  the  nose,  and  obstruction  of  the  air 
current.  Dullness  on  percussion  will  show  the  filling  of  the 
.sinuses.  These  conditions  must  be  carefully  differentiated  from 
actinomycosis,  sarcoma  and  other  morbid  growths  in  the  same 
situation. 

Costiveness  with  foetor  and  lack  of  the  normal  color  in  the 
stools  may  suggest  liver  torpor  or  inflammation,  while  fatt}'  stools 
may  suggest  pancreatic  disea.se.  The  uneasy  movements  of  colic, 
should  lead  to  a  careful  investigation  of  the  chylo-poietic  organs 
(see  digestive  organs).  Weakness  of  the  hind  parts,  tenderness 
of  the  loins,  and  altered  condition  of  the  urinary  discharge  .should 
demand  a  close  enquiry  into  the  .state  of  the  kidneys  and  bladder. 
Satyriasis  or  nymphomania  would  suggest  disease  of  the  ge7ier- 
ative  organs  or  the  nerve  centres  that  preside  over  them.  The 
same  is  true  of  impotence,  sterility  and  abortion. 


Syjnptomatology.     Semeiology.  27 

In  eruptions  on  the  skin  (erythema,  eczema,  pustule,  squama) 
a  cause  may  be  found  in  the  local  action  of  heat,  friction,  or  other 
direct  irritant,  but  in  the  absence  of  any  such  manifest  cause,  an 
enquiry  should  bs  made  into  the  functions  of  sanguification, 
digestion,  urination  and  the  action  of  the  liver.  It  may  further 
suggest  parasitism  (ring  worm,  phthiriasis,  fleas,  acariasis,  ver- 
minous disease,  etc. ) 

Symptoms  of  nervous  disorder  are  too  numerous  tO  be  here 
traced  to  local  lesions.  Motor  paralysis  of  one  limb  may,  how- 
ever, suggest  injury  to  its  motor  nerves,  to  the  same  side  of  the 
spinal  cord,  or  of  the  oppo.site  half  of  the  cerebrum.  Paraplegia 
almost  always  indicates  injury  to  the  cord.  Senory  paralysis  of 
one  .side  may  depend  on  disease  of  the  opposite  corpus  striatum. 
The  animal  moves  in  a  circle  when  a  tumor  (coenurus  in  sheep) 
exists  in  the  roof  of  the  lateral  ventricle  presumably  pressing  on 
the  ganglia  on  its  floor.  An  animal  rolls  on  its  axis  when  there 
is  a  lesion  of  the  median  cerebral  peduncles,  of  the  supero-ex- 
ternal  portion  of  these  peduncles,  of  the  posterior  part  of  the  ence- 
plialon,  or  of  different  parts  of  the  hemisphere.  Amaurosis  sug- 
gests disease  of  the  corpora  quadrigeminia.  I^oss  of  coordina- 
tion of  muscular  movement  usually  implies  some  lesion  of  the 
cerebellum.  Vertigo  may  imply  disease  of  the  encephalon  (con- 
gestion, anaemia,  inflammation,  dropsy,  haemorrhage,  tumor, 
abscess)  ;  it  may  be  disease  of  the  internal  ear  ;  it  may  be  diges- 
tive disorder  connected  often  with  cryptogamic  poisoning  ;  it  may 
be  heart  disease  with  obstruction  of  the  jugular  veins  ;  it  may  be 
parasites  in  the  nasal  sinuses  ;  or  it  may  be  disease  of  the  eye. 
Coma  occurs  in  most  congestions  and  pressures  on  the  encephalon, 
and  like  vertigo  in  poi.soning  by  alcohol,  solanine,  monoxide  of 
carbon,  etc.  In  acting  on  any  ganglionic  centre  the  agent  may, 
according  to  its  degree,  operate  positively  or  negatively,  produc- 
ing spasms,  or  paralysis  as  the  case  may  be.  As  in  the  case  of 
other  visceral  affections  the  specific  diseases  must  be  referred  to  for 
particular  symptoms. 

For  the  more  precise  points  in  diagnosis,  including  chemical, 
phy.sical,  electrical  and  instrumental  methods,  etc.,  the  reader  is 
referred  to  the  special  diseases. 


PROGNOSIS. 

Definition.  Demands  on  the  veterinarian,  the  question  of  economy. 
Basis  of  Prognosis.  Cause  of  the  illness,  internal  or  external,  vital  or  non- 
vital  organ,  enzootic,  fatigue,  infection,  in  one  or  two  symmetrical  vital 
organs,  regular  or  irregular  in  its  course,  persistence,  relapse,  complications, 
effect  of  treatment,  appetite,  temperature,  pulse,  breathing,  youth,  age,  de- 
bility, previous  disease,  breeding,  climate,  season. 

Prognosis  is  a  more  complicated  question  for  the  veterinarian 
than  for  the  ph3\sician.  The  latter  must  pronounce  on  the 
malady,  whether  it  is  likely  to  follow  a  regular  or  irregular 
course,  whether  it  will  last  short  or  long,  whether  it  will  be 
curable  or  incurable,  and  if  curable  whether  recovery  would 
be  complete  or  partial.  For  the  veterinarian  there  is  in  ad- 
dition the  question  of  economy.  The  veterinary  patient  is, 
as  a  rule,  of  value,  only  if  he  can  be  rendered  sound,  and  a 
partial  recovery  may  be  even  worse  than  a  fatal  result,  since  the 
subject  remains  as  a  ruinous  charge  on  his  owner.  The  veterin- 
arian must  pronounce  on  the  prompt  and  perfect  curability  of  the 
case,  on  the  outlay  that  will  be  requisite  for  treatment,  on  the  de- 
preciation which  will  be  entailed  on  the  patient,  and  whether,  in 
certain  lesions  that  do  not  harm  the  carcase,  it  would  not  be  more 
judicious  to  butcher  the  subject.  The  physician  is  expected  to 
do  the  best  he  can  for  life  and  health,  and  even  a  very  imperfect 
recovery  brings  him  a  mead  of  gratitude.  The  veterinarian  on 
the  other  hand  must  be  an  expert  not  only  on  disease,  but  on 
animal  values,  and  if  his  treatment,  however  skillful  it  may  be. 
results  only  in  the  prolonging  of  the  life  of  an  useless  animal, 
the  owner  may  charge  him  with  imposing  upon  him  an  unneces- 
sary outlay.  The  soundest  judgment  and  highest  skill  are  often 
necessary  to  secure  the  interests  of  an  employer  in  such  circum- 
stances. In  certain  cases  the  recommendation  to  destroy  is  of 
much  more  value  to  the  employer  than  the  most  skillful,  and  par- 
tially effective,  curative  treatment.  On  this  basis,  the  reputation 
of  a  skillful  man  may  be  securely  built.  He  can  deceive  no  one 
if  his  prediction  of  recovery  is  not  justified,  while  if  he  advises 
destruction  and  the  patient  recovers,  he  is  at  once  discredited. 


Prognosis.  29 

To  give  a  sonud  prognosis  the  practitioner  must  have  a  thor- 
ough knowledge  of  pathology,  he  must  have  acute  powers  of  ob- 
servation, and  he  must  be  quick  to  appreciate  every  point  that 
makes  for  or  against  the  patient  in  the  particular  case. 

The  causes  of  the  trouble  must  be  carefully  considered.  Are 
they  transient  or  permanent  ?  Are  they  removable  or  irremova- 
ble ?  x\re  they  external  or  internal  ?  As  a  rule  an  internal 
cause  is  the  more  redoubtable.  Some  lesions  are  necessarily  fatal, 
as  a  needle  penetrating  the  heart  or  an  attack  of  rabies  or  milk 
sickness.  Is  the  cause  an  enzootic  one?  If  so  can  the  patient  be 
removed  from  the  locality  ?  Is  it  a  fatigue  fever  or  an  infectious 
one?  Is  it  a  simple  inflammation  or  an  infecting  one?  The  lat- 
ter are  usually  much  more  grave.  In  case  of  contagious  disease, 
can  its  propogation  be  prevented?  Is  it  of  a  fatal  or  non-fatal 
type?  Is  it  situated  in  a  tis.sue  favorable  to  a  fatal  exten.sion, 
(anthrax  in  lung)  or  in  one  unfavorable  (anthrax  in  the  tip  of 
the  tail)  ?  Disease  in  a  single  vital  organ  like  the  heart  is  neces- 
arily  much  more  grave  than  in  one  of  a  symmetrical  pair  (kid- 
neys, lungs)  one  of  which  can  carry  on  the  functions.  The  reg- 
ular progress  of  the  disease  and  especially  an  uninterrupted  im- 
provement, following  on  a  critical  perspiration  or  urination,  is  a 
good  prognostic  sign,  whereas  unevenness  of  temperature,  pul.se 
and  respiration,  with  temporary  aggravations  of  the  general  symp- 
toms, should  demand  a  less  hopeful  prognosis.  The  persistence 
of  the  malady  is  also  an  unfavorable  indication.  A  relapse  after 
partial  recovery  is  a  serious  indication  unless  due  to  some  obvious 
and  easily  removable  cause,  and  unless  the  former  convalescent 
condition  is  .speedily  restored  on  its  removal.  A  complication  is 
a  serious  indication  whether  it  consists  in  an  embolism,  or  new 
centre  of  the  same  disease,  or  the  supervention  of  a  second  dis- 
ease upon  the  first.  The  .system  has  ju.st  so  much  more  to  con- 
tend with  and  the  very  .supervention  of  the  second  focus  or  malady 
argues  a  special  su.sceptibility,  debility,  or  lessened  power  of  re- 
sistance. 

The  prompt  success  or  entire  insucce.ss  of  treatment  proves  val- 
uable. 

The  preservation  of  appetite,  the  slow,  uniform  descent  of  the 
temperature,  and  the  improvement  of  pulse  and  breathing  are 
among  the  most  valuable  indications. 


30  Veterinary  Medicine. 

Something  may  be  deduced  from  the  condition  of  the  patient. 
If  very  young  or  old,  debiHtated  by  over-work,  bad  or  insufficient 
food,  previous  disease,  or  any  other  cause,  the  prognosis  is  less 
hopeful,  as  it  is  also  as  a  rule,  during  gestation,  in  the  parturient 
state,  or  if  abortion  ensues.  A  hereditary  predisposition  to  the 
malady  in  question  is  equally  unfortunate. 

Climate  may  be  an  important  factor.  Thus  liver  diseases  are 
far  more  to  be  dreaded  in  a  damp  tropical  or  semi-tropical  region, 
and  rheumatism  and  catarrhal  affections  in  winter  and  in  cold 
northern  localities.  Acclimatization  should  also  be  considered. 
The  bovine  animal,  raised  on  the  Gulf  Coast  is  likely  to  make  a 
good  recovery  from  Southern  Cattle  Fever  while  the  northern 
beast  would  almost  certainly  die. 

All  in  all  the  question  of  prognosis  cannot  always  be  judiciously 
decided  at  a  first  visit,  and  for  the  sake  of  his  own  reputation,  it 
is  well  that  the  practitioner  should  give  only  a  qualified  opinion 
at  first  until  he  can  certify  himself  as  to  the  probable  outcome  of 
the  disease. 


PROPHYLAXIS.     PROPHYLACTICS.    PREVENTION. 

A  test  of  public  sentinieut.  Soil.  Water.  Exposure.  Buildings.  Local 
hygiene.     Breeding.     Diet.     Work.     Harness.     Ventilation. 

With  adv^ancing  knowledge  of  veterinary  medicine  the  subject 
of  prophilaxis  is  steadily  assuming  a  more  important  place,  and 
especially  in  the  classes  of  enzootic  and  epizootic  diseases.  In- 
deed for  the  fatal  infectious  diseases  of  animals  one  can  fairly  esti- 
mate the  medical  intelligence  of  the  people  by  the  extent  to  which 
therapeutic  treatment  is  still  allowed.  With  economy  as  the 
great  central  object  of  veterinary  medicine,  the  problematical  re- 
covery of  the  few  can  never  balance  the  assured  preservation  of 
the  many.  But  this  subject  belongs  to  contagious  diseases  to 
which  the  reader  is  referred. 

In  enzootic  affections,  improvements  in  soil,  water,  exposure, 
buildings,  and  other  local  unhygienic  conditions,  are  the  final 
ends  to  be  sought,  according  to  the  particular  nature  of  the  pre- 
vailing disease. 

So  in  sporadic  diseases  the  correction  of  faults  in  breeding, 
hygiene,  diet,  water,  work,  harness,  exposure,  buildings,  venti- 
lation, etc.,  are  called  for  in  different  cases  as  will  be  noted  under 
the  individual  diseases. 


31 


THERAPEUTICS.     TREATMENT. 

Defitiilion.  Mechanical  and  Medicinal  Therapeutics.  Adaptation  to  each 
case  of  disease. 

The  tiltimate  object  of  all  medicine  is  to  prevent  disease  or 
when  it  cannot  be  prevented,  to  cure.  The  term  therapeutics 
covers  all  measures  applied  with  curative  object.  Therapeutics 
are  naturally  divided  into  Mechanical  and  Medicinal.  To  me- 
chanical therapeutics  pertains  the  whole  domain  of  surgery.  Me- 
dicinal therapeutics  has  to  do  especially  with  internal  medicine. 
Each  of  them,  however,  encroaches  more  or  less  on  the  other. 
Modern  surgery  is  essentially  aseptic  or  anti.septic,  and  antisepsis 
is  secured  by  medicinal  agents.  In  medicine  when  cups  are  ap- 
plied we  adopt  an  essentially  mechanical  treatment.  Both  meth- 
ods then  must  remain  open  to  physician  and  surgeon.  Another 
and  no  less  important  branch  of  treatment  which  is  open  to  phys- 
ician and  surgeon  alike  is  diet  and  general  hygiene.  The  same 
care  must  be  given  to  the  use  of  these  in  the  treatment  of  disease 
as  in  its  prevention,  and  in  many  cases  a  judicious  use  of  the.se 
may  almo.st  entirely  obviate  the  necessity  for  medicine. 

It  would  be  useless  to  enter  here  into  the  subject  of  therapeu- 
tics. Suffice  it  to  say  that  the  choice  of  a  .system  and  of  individ- 
ual agents  must  be  determined  by  the  particular  conditions  of  the 
case,  its  cause,  and  nature,  the  strength,  vigor,  and  genus  of  the 
patient,  the  organ  involved,  the  extent  and  stage  of  the  disease, 
the  existence  of  a  relapse,  or  complication,  and  all  other  circum- 
stances that  would  affect  the  action  of  the  remedy.  Specific  state- 
ments mu.st  be  made  with  the  several  diseases. 


32 


HYPEREMIA.     CONGESTION. 

Definitiou.  Forms,  active — arterial,  passive — mechanical — venous.  De- 
termination of  blood.  Causes  of  active  congestion.  Vaso-raotor  nerves. 
Lesion  of  spinal  cord  ;  or  of  sympathetic  nerve.  Reflex  irritation.  Cen- 
tral cause.  Physiological  hyperaemia.  Medicinal  hypersemia.  Bacteri- 
dian  (toxic)  hyperemia.  Arterial  obstruction.  Thrombus,  tumor.  Cold, 
chill.  Removal  of  pressure.  Cardiac  hypertrophy.  Symptoms,  bright 
red  color,  swelling,  dropsy,  migration  of  cells.  Rise  of  local  temperature. 
Tenderness.  Altered  function.  Causes  of  passive  congestion.  Obstructions 
in  the  lungs,  heart,  veins.  Diminished  force  of  circulation  from  age,  de- 
bility, arterial  disease,  distance  from  the  heart,  decubitus,  vaso-motor  dis- 
order. Gravitation— hypostatic  congestion.  Tumors.  Paresis.  Symp- 
toms. Cyanosis.  Distended  veins.  Coldness.  Transudation — watery. 
Haemorrhage.  Thrombus.  Hyperplasia.  Atrophy.  Postmortem  lesions. 
Treatment.  Remove  Cause.  Correct  injurious  gravitation.  Correct  any 
fault  in  blood  pressure.  Derivation.  Constringe  or  support  part.  Mas- 
sage.    Electricity.     Improve  general  health. 

Definition.  An  excess  of  blood  in  a  part.  It  is  distinguished 
from  inflammation  by  the  absence  of  that  tissue  reaction,  which 
leads  to  or  constitutes  the  special  phenomenon  of  that  morbid  pro- 
cess. 

Hypersemia  is  divided  into  active  or  arterial  and  passive,  me- 
chanical or  venous.  A  capillary  form  has  also  been  described 
but  usually  capillary  congestion  is  seen  in  both  the  arterial  and 
venous  types. 

I.  Active  or  Arterial  Determination  of  blood.  In  this 
form  the  arteries  are  dilated  under  a  direct  nervous  influence. 
Causes.  In  all  the  regular  functions  of  the  body,  the  flow  of 
blood  is  under  the  direct  control  of  the  vaso-motor  nerves  which 
proceed  from  the  spinal  cord,  through  the  branches  of  the  sympa- 
thetic to  be  distributed  with  the  blood  vessels.  The  hard  pulse  of 
pleurisy  is  due  to  rigid  contraction  of  the  constrictor  muscles  under 
the  action  of  the  vaso-motor  nerves,  and  the  blush  of  shame  is  due 
to  their  relaxation.  Some  claim  an  active  dilatation  of  the  arte- 
rial muscular  coats,  others  look  more  simply  upon  the  dilatation 
as  a  mere  yielding  of  the  coats  under  the  blood  pressure,  when 
the  constrictor  muscles  are  relaxed.  This  vaso-motor  paresis  may 
be  induced  :   ist,  by  any  lesion  of  the  spinal  cord.     2d,   by  the 

3 


34  Veterinary  Mediciyie. 

cutting  of  a  sympathetic  trunk,  that  of  the  abdomen,  for  example, 
which  leads  to  active  congestion  of  the  abdominal  viscera,  or  the 
section  of  the  cervical  sympathetic  which  leads  to  watering  of  the 
eye,  sweating,  congestion,  and  scabbing  on  the  corresponding 
half  of  the  face.  3d,  by  reflex  irritation  through  the  sensory 
nerves,  as  in  congestion  through  friction,  heat  or  cold  to  the  skin, 
or  that  resulting  from  excessive  use  of  an  organ  such  as  the 
mammary  gland.  4th,  by  causes  acting  directly  through  the 
brain  as  in  emotional  blushing  or  the  facial  congestion  of  violent 
rage. 

Physiologically  we  see  the  operation  of  this  nervous  control  in 
the  congestion  of  the  gums  during  dentition,  of  the  .salivary  glands 
during  mastication,  of  the  stomach  and  bowels  during  dige.stion, 
of  the  womb  during  gestation,  of  the  mammae  at  parturition,  and 
of  erectile  organs  in  copulation. 

Medicinal  agents  act  in  the  same  way,  opium  or  alcohol  pro- 
ducing active  dilatation,  and  belladonna  and  ergot  causing  active 
contraction  of  the  arterial  walls. 

Bacteridian  poisons  act  in  the  same  way,  tuberculin  and  a  num- 
ber of  others  causing  active  dilatation. 

The  obstruction  of  one  artery  by  thrombus,  tumor,  or  ligature, 
causes  increased  tension  in  the  collateral  branches  coming  off  just 
above  and  an  active  congestion  in  the  parts  to  which  these  are 
distributed.  While  this  is  directly  due  to  increased  local  pres- 
sure, it  is  also  an  instance  of  the  lack  of  balance  between  the  blood 
pressure  and  the  resistance  of  the  vascular  walls.  In  this  case 
there  is  increase  of  pressure,  in  the  other  a  diminished  resistance. 

If  there  is  a  superficial  anaemia,  as  from  cold  or  chill,  there  is  of 
necessity,  an  internal  hyperaemia.  This  contributes  to  the  pro- 
duction of  internal  congestions  and  inflammations,  though  the 
seat  of  election  of  such  inflammation  is  usually  determined  by  the 
nervous  sympathy  between  the  part  chilled  and  the  deeper  organ 
affected. 

Another  cause  of  congestion  is  the  lessening  of  pressure  by  the 
parts  surrounding  the  vessel.  Thus  in  cupping,  there  is  prompt 
cutaneous  congestion,  and  a  similar  result  occurs  in  pericardium, 
pleura,  or  peritoneum  on  the  withdrawal  of  the  liquid  of  hydro- 
pericardium,  hydro-thorax  or  ascites. 

Another  cause  of  congestion  is  found  in  hypertrophy   of  the 


Hyper-czmia.      Congestion.  35 

heart  and  increased  force  of  the  blood  flow  (blood  tension) .  In 
such  cases  those  organs  become  congested  in  which  there  is  some 
previous  debility  or  disease  of  the  blood  vessels. 

Symptoms  and  results.  The  symptoms  are  a  bright  vermillion 
redness,  tension  or  swelling,  heat  and  tenderness.  Pulsation  is 
stronger  in  the  vessels  leading  into  the  part,  secretions  tend  to 
increase  but  may  give  place  to  a  serous  effusion  or  haemorrhage. 
The  bright  redness  is  attributed  to  the  rapid  circulation  of  the 
red  globules  which  have  not  time  to  give  up  their  oxygen  to  the 
tissues.  It  is  sharply  circumscribed  where  the  affected  arterioles 
have  no  free  anastomosis  with  those  of  neighboring  parts,  diffuse 
where  anastomosis  is  abundant,  and  when  on  the  skin  it  is  liable 
to  rise  in  knots  or  buttons  as  in  urticaria.  When  pressed  the 
redness  entirely  disappears  unlike  the  redness  of  inflammation. 

The  swelling  may  be  due  to  the  simple  turgescence  of  the  blood- 
vessels, but  also  often  to  transudation  of  serum  as  in  and  around 
the  cow's  udder  at  parturition.  The  occasional  migration  of 
globules,  and  their  escape  through  minute  lacerations  in  the  vas- 
cular walls  add  alike  to  color  and  turgescence. 

The  elevated  temperature,  (rising  sometimes  3°  C.)  in  the  con- 
gested area,  is  attributed  to  the  more  active  circulation,  and  Schiff 
prevented  its  appearance  after  section  of  the  cervical  sympathetic, 
by  tying  the  carotid  and  vertebral  arteries  on  the  same  side. 

The  tenderness  of  the  congested  parts  varies  inversely  as  the 
looseness  of  texture  and  the  facility  for  swelling.  It  may  be 
scarcely  perceptible  in  the  mammary  region,  and  intense  under 
the  horn  or  hoof. 

The  functions  in  the  congested  organ  are  often  seriously  in- 
terfered with,  secretions  appearing  in  excess  or  entirely  altered. 
When  the  congestion  lasts  it  may  cause  li3^pertrophy,  induration 
or  hyperplasia,  these  are  however  rather  sequels  than  lesions  of 
the  condition.  Simple  congestion  is  usually  quite  transient,  and 
if  prolonged,  often  merges  into  inflammation. 

II.  Passive  or  Venous  Congestion.  In  this  there  is  no  ex- 
cess of  blood  entering  the  part,  but  the  regular  supply  is  delayed 
in  the  veins  by  some  obstruction,  and  these  vessels  and,  later,  the 
capillaries  are  gorged  with  black  blood. 

Causes,  ist,  Mechanical  obstruction  to  the  onward  flow  of 
blood,  as  in  the  case  of  disease  of  the  lungs  hindering  the  flow  of 


36  Veterinary  Medicine. 

blood  from  the  right  heart  ;  disease  of  the  right  heart  allowing  a 
reflux  of  blood  into  the  veins  ;  or  pressure  by  tumors  or  other- 
wise on  the  great  or  small  venous  trunks.  If  in  the  heart  or 
lungs  the  whole  systemic  venous  system  becomes  the  seat  of  pas- 
sive congestion  ;  if  in  a  single  venous  trunk  then  only  the  parts 
the  venous  radicles  of  which  are  tributary  to  this.  We  find  ex- 
amples of  this  in  phlebitis,  in  compression  by  the  swellings  of 
strangles,  in  the  result  of  a  bandage  or  ligature  tied  round  a  limb 
at  some  distance  from  its  extremity,  and  in  the  compression  of 
the  iliac  veins  by  a  gravid  womb. 

2d.  Diminished  force  of  the  blood  current  in  the  veins,  as  from 
old  age  or  great  debility  and  especially  from  weakness  of  the 
heart's  action.  Also  from  disease  of  the  arterial  coats  which  im- 
pairs their  tonicity.  The  force  being  too  weak  to  force  the  blood 
actively  through  the  capillaries  and  veins,  it  becomes  imduly 
charged  with  carbon  dioxide  and  other  products  of  tissue  waste, 
so  that  nutrition  suffers  and  the  walls  of  the  capillaries  lose  their 
vital  force.  This  condition  is  aggravated  in  the  hind  limbs  by 
the  distance  from  the  heart,  and  the  dependent  position,  and  in 
decubitus  by  the  compression  of  the  vessels  of  the  limbs.  Also 
by  injuries  to  the  vaso-raotor  nerve  supply  as  oedema  appeared 
in  the  hind  limb  after  tying  of  the  femoral  vein  in  animals  the 
abdominal  sympathetic  of  which  had  been  cut,  but  not  in  animals 
in  which  this  nerve  was  left  in  its  normal  condition   (Ranvier). 

3d.  Gravitation  in  weak  states  of  the  circulation  must  be  looked 
upon  as  a  cause  of  venous  congestion.  This  is  seen  in  the  ex- 
amples of  hypostatic  congestion  and  oedema  seen  in  the  lungs  and 
other  internal  organs  in  low  conditions  and  in  the  advanced  stages 
of  debilitating  diseases,  and  in  certain  cases  of  stocking  of  the 
limbs  in  horses. 

4th.  Valvular  insufficiency  of  the  left  heart  and  tumors  or 
aneurisms  interfering  with  circulation  through  the  aorta,  cause 
passive  congestion  of  the  pulmonary  veins  and  oedema  of  the  lung. 

5th.  Tumors  and  diseases  of  the  liver  determine  passive  con- 
gestion of  the  portal  system  and  ascites. 

6th.  Passive  congestion  is  very  liable  to  take  place  in  an  organ 
the  functions  of  which  are  impaired  as  in  a  paralyzed  part.  In 
this  the  hypersemia  may  start  in  the  capillaries  and  extend  to  the 
veins  or  even  to  the  arteries. 


Hyperczviia.      Congestion.  37 

Symptoms  and  results.  If  on  a  mucous  membrane  or  white 
skin  the  color  becomes  dark  red,  or  violet  (cyanotic)  with  evident 
distension  of  the  capillaries  and  veins,  the  latter  of  which  may- 
stand  out  as  knots  or  cords,  there  is  an  appearance  of  swelling  or 
enlargement  and  sometimes  coldness  of  the  part.  Soon  the  wa- 
tery part  of  the  blood  transudes  in  excess,  constituting  dropsy, 
with  increased  swelling  and  pitting  on  pressure.  On  the  mucous 
surfaces  it  determines  an  abundant  serous  secretion.  The  color 
is  deepened  by  the  escape  from  the  vessels  of  red  globules  as  well 
as  white.  The  transudation  contains  little  albumen  and  only 
exceptionally  fibrine.  In  connection  with  the  marked  deoxidation 
and  high  carbonisation  of  the  blood,  the  nutrition  of  the  part  is 
largely  arrested  together  with  the  functions,  secretory,  motor  or 
otherwise.  The  imperfectly  nourished  vessels  may  give  way, 
leading  to  haemorrhage,  or  nutrition  may  be  definitely  arrested 
producing  moist  grangrene  or  ulceration.  Sometimes  a  thrombus 
is  formed  in  a  congested  vein.  The  changes  in  the  affected 
organs  depend  much  on  the  degree  and  duration  of  the  hyperae- 
mia.  If  slight  and  lasting  it  causes  permanent  induration  and 
thickening,  from  connective  tissue  hyperplasia  as  frequently  seen 
in  the  hind  limbs  of  the  horse.  In  case  of  blood  transudations 
the  altered  coloring  matter  gives  the  various  shades  of  gray, 
brown  or  black.  If  long  continued  the  organ  may  shrink  and 
atrophy  occur  from  defective  nutrition  and  contraction  of  the 
fibrous  hyperplasia. 

In  making  post  mortem  examinations  mistakes  may  be  made 
through  the  occurrence  of  changes  after  death.  Thus  a  hyperse- 
mia  which  was  quite  considerable  during  life  may  virtually  disap- 
pear through  the  contraction  of  the  arterial  and  capillary  coats 
forcing  the  blood  on  into  the  veins.  A  minute  point  of  extrava- 
sation here  and  there  may  be  the  only  macroscopic  lesion  left. 
Again  a  marked  venous  and  capillary  hypersemia  in  a  dependent 
part  of  the  body  or  of  an  organ  may  be  entirely  due  to  hypostatic 
conditions,  the  blood  having  settled  into  the  lowest  part  of  the 
vessels  since  the  death  of  the  animal.  To  avoid  this  source  of 
error  one  must  always  carefully  note  the  position  of  the  carcass 
after  death.  Under  other  circumstances  the  superficial  veins  and 
capillaries  may  fill  up  with  blood  through  the  occurrence  of  de- 
composition and  the  evolution  of  gases  in  the  internal  cavities, 
which  empty  the  splanchnic  and  parietal  vessels  by  compression. 


38  Veteri7iary  Medicine. 

Treatment.  The  general  principles  of  treatment  may  be  stated 
thus :  ist.  Remove  the  cause  of  the  hyperaemia  if  possible, 
especially  any  mechanical  cause  ;  2d.  Secure  the  influence  of 
gravitation  in  favor  of  the  return  of  blood  to  the  heart ;  though 
not  so  available  in  animals  as  in  man,  it  is  of  great  value  in  con- 
gestions of  the  head,  ears,  tail,  and  to  a  less  extent  of  other 
parts  ;  3d.  Correct  any  fault  of  blood-pressure,  excess  or  defi- 
ciency, which  may  act  so  as  to  cause  active  or  passive  hyperaemia; 
4th.  Establish  derivation  by  cupping,  leeches,  fomentations, 
pediluvia,  sinapisms,  etc. ;  5th.  Apply  cold,  astringents,  bandages, 
to  empty  the  hyperaemic  vessels,  or  kneading,  rubbing,  or  elec- 
tricity, to  hasten  the  flow  of  blood  ;  6th.  To  improve  the  quality 
of  the  blood  and  general  health,  in  plethora  by  low  diet,  purga- 
tives and  diuretics,  in  anaemic  or  debilitated  conditions  by  iron, 
bitters,  nourishing  food,  fresh  air,  sunshine  and  exercise. 

It  is  especially  important  to  check  passive  congestion  in  febrile 
diseases,  and  mechanical  congestion  at  an  early  stage  of  its  pro- 
gress (Roberts). 


INFLAMMATION.     PLOGOSIS.     PHLEGMASIA. 

Definitions.  Relations  to  active  byperaemia.  Redness.  Heat.  Pain. 
Swelling.  Forms  :  in  vascular  tissues  :  in  non-vascular.  Changes  in  tissiie 
elements.  Death  of  cells.  Cloudy  swelling.  Granular  degeneration.  Cell 
proliferation.  Karyokinesis.  Embryonic  cells.  Amoeboid  functions. 
Migration  of  leucocytes.  Red  cells  escaping.  Changes  in  innervation. 
Vaso-motor  disorders.  Fever.  Changes  in  circulation.  Contraction  of 
capillaries,  dilatation,  rapid  flow,  tardy  flow,  stasis,  oscillations,  thrombus, 
collecting  of  white  globules  in  periphery  of  current,  migration  of  leucocytes, 
blood  plates,  and  red  globules,  massing  of  red  globules,  exudation,  soften- 
ing of  the  capillary  walls,  nutrient  artery  more  rigid  and  transmits  more 
blood,  heart  contracts  more  forcibly,  increase  of  fibrine,  ncrease  of  waste 
products.  BufFy  coat,  physiological  causes.  Microbes.  Ptomaines. 
Toxins.  Chemiotoxis.  Phagocytosis.  Polynuclear  and  mononuclear  leu- 
cocytes. Exudates,  unlike  dropsies.  Mucous  exudate.  Serous  exudate. 
Fibrinous  exudate.  Blood  exudations.  Croupous  exudation.  Chyliform 
exudate.  Results  and  Products.  Resolution.  Deletescence.  Metastasis. 
New  formations.  Suppuration.  Pus  microbes.  Pus.  Healing  by  ist  in- 
tention. Healing  by  2nd  intention,  granulation.  Granule  corpuscles.  In- 
terstitial neoplasia.  Degenerations  in  lymph.  Fatty  degeneration, 
melanotic.     Softening.     Ulceration.     Gangrene. 

Inflammation  has  been  variously  defined  as  "perverted  nutri- 
tion," as  a  "  protective  reaction  of  the  organism  against  irritant 
agents  "  and  in  other  terms  that  express  at  once  too  much  and  too 
little,  without  actually  defining  the  morbid  process.  Older  defini- 
tions dealt  with  the  manifest  disorders  of  circulation,  of  innerva- 
tion or  of  tissue  change  too  often  exalting  the  importance  of  one 
set  of  changes  at  the  expense  of  another  and  thus  giving  in  the 
main  a  one  sided  view  of  the  morbid  process. 

Some  modern  bacteriologists  are  inclined  to  refuse  the  title  to 
any  morbid  process  that  is  not  caused  by  the  presence  of  microbes 
or  their  toxic  products.  To  them  the  changes  occurring  in  an 
aseptic  wound  or  in  a  simple  fracture  in  process  of  healing  are 
purely  reparatory  and  partake  no  more  of  the  nature  of  inflamma- 
tion than  do  the  developmental  changes  in  the  growing  embryo. 
While  to  a  large  extent  true,  this  exclusive  view  implies  excep- 
tions, since  if  the  chemical  poisons  derived  from  the  bacteria  can 
develope  inflammation,  the  same  must  be  admitted  as  possible  for 
chemical  irritants  drawn  from  other  sources. 

39 


40  l^eUrinary  Medicine. 

As  a  matter  of  fact  inflammation,  occurring  as  it  does  in  ver\- 
different  tissues,  vascular  and  nonvascular,  fibrous,  cellular, 
jmrenchymatous,  etc. ,  and  in  connection  with  a  great  variety  of 
irritants,  must  be  held  to  include  a  large  group  of  morbid  pro- 
cesses, bearing  to  each  other  a  strong  family  relationship  and  re- 
semblance, and  yet  differing  in  man\'  important  details.  Each 
irritant  (heat,  cold,  electricity,  chemical  irritant,  incised,  punc- 
tured, lacerated  or  contused  wound,  rupture,  fracture,  foreign 
body,  parasite,  microbe,  toxin,  etc.,;  has  its  own  special  charac- 
ter and  mode  of  irritation  ;  each  tissue  has  its  own  special  method 
of  succumbing  or  reacting  and  its  own  amount  of  blood  supply  ; 
and  each  system  and  organ  has  its  own  native  or  acquired  power 
of  resistance  and  reaction. 

Inflammation  agrees  with  active  h3-i)ersemia  in  the  tendency  to 
dilation  of  the  vessels  and  an  increased  flow  of  blood  to  the  part  or 
if  the  irritated  part  is  nonvascular  like  the  cornea  or  articular 
cartilage,  then  to  the  parts  adjacent.  It  differs,  however,  in  the 
more  active  cell  proliferation,  and  in  the  nature  of  the  Hquid 
transudation  which  is  richer  in  albumen  fibrine.  cells  and  phos- 
phates. Abstractly  the  inflamed  part  retains  very  active  vital 
processes,  trophic  and  exudative,  but  these,  are  largely  changed 
from  the  normal  and  are,  it  is  claimed.  per\-erted,  yet  they  pre- 
side over  the  processes  of  cell  growth  and  decay,  the  removal  of 
injured  or  useless  tissue,  and  later,  over  the  building  up  of  new 
material,  and  repair  of  loss.  Active  h^peraemia  on  the  other 
hand  is  mainly  a  circulatory  disorder,  and  when  it  advances  so  as 
to  determine  changes  in  the  cells  and  tissues  it  is  held  to  have 
merged  into  inflammation. 

The  term  inflammation  (from  inflammo.  I  set  on  fire  ) ,  is  sugges- 
tive of  the  local  heat  of  the  inflamed  part,  just  as  fever  ( febris) 
indicates  an  elevation  of  the  temperature  of  the  bod\-  at  large. 
Celsius  enumerated  the  features  of  robor.  calor,  dolor  and  tumor 
(redness,  heat,  pain  and  swelling  i  which  have  come  down  to  our 
own  time  as  at  least  suggestive  of  inflammation.  But  any  diag- 
nosis, based  on  these  alone,  would  be  today  woefulh'  inadequate. 
Redness  occurs  in  the  transient  blush,  heat  in  the  febrile  state, 
though  no  inflammation  can  be  recognized,  pain  is  present  in 
neuralgic  and  other  ner\-ous  affections,  and  swelling  in  dropsy  and 
ttmior.     On  the  other  hand  redness  is  entirely  absent,  for  a  time, 


hiflamation.      Plogosis.     Phlegmasia.  41 

after  the  outset  of  infiainniation  in  nonvascular  tissues  (cornea, 
articular  cartilage ) ,  the  heat  of  the  inflamed  part  may  be  actu- 
ally' lowered  when  there  is  much  exudation  around  the  capillary 
vessels  and  lessened  flow  of  blood,  pain  may  be  absent  in  some 
circumscribed  inflammations  of  the  lungs,  and  swelling  is  not  at 
first  visible  in  the  inflamed  cornea  or  compact  bony  tissue.  These 
phenomena  which  are  so  common  in  inflammation  and,  in  general 
so  characteristic  of  it,  cannot  therefore  be  accepted  as  infallible 
evidence  of  its  existence,  nor  can  their  absence  be  held  as  abso- 
lutely imph'ing  its  nonexistence. 

Forms  of  Inflammation.  This  morbid  process  might  be 
divided  almost  indefinitely  according  to  the  organ  invaded,  the 
cause,  and  type,  yet  it  will  be  more  convenient  to  deal  with  it 
generically  and  notice  inflammation  in  nonvascular  and  vas- 
cular tissues  re.'=pectively,  and  the  different  types  of  granular 
degeneration,  exudative  inflammation  and  croupous  inflam- 
mation. It  will  be  requisite  further  to  notice  an  acute  and  a 
chronic  type. 

By  dealing  first  with  the  changes  in  the  anatomical  elements  of 
the  tissues  and  in  the  innervation,  we  shall  virtually  cover  the 
phenomena  observed  in  nonvascular  tissues,  and  later  the  changes 
in  connection  with  the  circulatory  system  will  give  the  additional 
characteristics  of  inflammation  in  vascular  tissues. 

CHANGES    IN    THE   TISSUE    ELEMENTS. 

Death  of  cells  and  tissue  By  the  application  of  an  irritant 
(acid,  heat,  etc.,)  a  certain  thickness  of  tissue  with  its  enclosed 
cells  is  killed,  and  a  thin  layer  of  necrosis  is  usually  produced. 
This  does  not  constitute  inflammation,  but  it  acts  as  a  foreign 
body,  often  septic,  in  producing  inflammation  in  the  parts 
adjacent. 

Cloudy  Swelling,  Granular  Degeneration.  This  may  occur 
in  the  inflamed  area  surrounding  the  necrosed  tissue  in  the  seat 
of  a  burn  or  other  injury,  it  is  exceedingly  common  in  the  cells 
of  inflamed  parenchymatous  tissue  (liver,  kidney),  in  the  muscle 
of  the  heart,  in  the  ga.stro-intestinal  mucosa,  in  febrile  affections 
and  in  poisoning  with  arsenic,  phosphorus,  or  mineral  acids.  The 
gross  appearance  of  the  tissue  is  that  of  swelling,   with  a  dull 


42  Veterinary  Medicine. 

gra3'ish  color  and  a  loss  of  its  normal  translucency.  The  cells  of 
the  affected  organs  are  seen  under  the  microscope  to  be  tilled  with 
small  albuminous  granules  which  may  be  so  abundant  as  to  com- 
pletely conceal  the  cell  structure.  The  granules  are  insoluble  in 
ether,  but  disappear  under  acetic  acid.  This  condition  of  the 
cells  is  often  associated  with  the  exudative  forms  of  inflammation. 

Cell  Proliferation  and  Change.  In  the  nonva.scular  organ 
attacked  by  inflammation  the  multiplication  of  tissue  cells  and 
their  resumption  of  amoeboid  movements  is  a  constant  phenome- 
non. Virchow  insi.sted  on  the  fundamental  relation  of  the  cell  to 
the  morbid  process,  and  Goodsir  and  Redfern  showed  the  rapid 
increase  of  the  cells  of  articular  cartilage  in  attacks  of  arthritis. 
There  is  first  a  sensible  increase  of  the  nucleus  of  the  cartilage 
cell  which  shows  a  more  extended  and  deeper  staining  in  carmine 
or  aniline  ;  then  by  a  special  method  of  division  (karyokinesis) 
the  cell  and  nucleus  divide  in  two  ;  by  a  .similar  process  these 
divide  in  four  and  so  on  in  regular  order.  Meanwhile  the  carti- 
laginous substance  becomes  softened  and  finally  dissolves  and  dis- 
appears, leaving  in  the  place  a  mass  of  closely  aggregated  cells. 

In  the  nonvascular  transparent  cornea,  the  membrane  of  Des- 
cemet,  the  epithelium  of  serous  membranes  and  in  the  epidermis 
a  similar  cell  multiplication  occurs,  also  in  the  lateral  cartilages  of 
the  horse's  foot. 

To  follow  the  indirect  cell  divi.sion  by  karyokinesis,  we  must 
note  the  cell  as  a  semi-solid  ma.ss,  formed  of  protoplasm  and 
nucleus,  each  having  as  its  framework  a  network  of  exceedingly 
fine  inter-crossing  filaments,  much  finer  in  the  nucleus  than  in 
the  cell  protoplasm.  The  nuclear  filaments  stain  with  hsematoxy- 
lon  and  safranin  and  are  called  chromatin  threads.  The  inter- 
vening non-staining  material  is  achro??iati7ie.  The  nucleus  has  a 
membraneous  envelope  in  two  layers,  of  which  the  inner  only 
stains.  When  about  to  divide  two  poles  are  formed  in  the  cell 
protoplasm  opposite  to  each  other  and  near  the  nucleus  the  fila- 
ments concentrating  to  the  poles.  The  chromatin  threads  in  the 
nucleus  thicken,  become  convoluted,  split  and  nuiltiply,  and  draw 
into  their  substance  the  chromatin  layer  of  the  envelope.  Next 
the  chromatin  threads  form  long  loops  directed  toward  an  achro- 
matine  centre  or  pole  like  a  star,  and  this  is  followed  by  the  pro- 
gressive division  of  the  star-shaped  mass  into  two  equal  parts. 


hifiamation.     Plogesis.     Phlegmasia.  43 

Finally  they  separate,  together  with  the  cell  protoplasm,  forming 
two  daughter  cells. 

This  cell  proliferation  under  the  action  of  an  irritant  is  com- 
mon to  the  vegetable  kingdom  in  which  galls,  and  tumors  are 
formed  in  this  way.  It  is  a  remarkable  feature  of  these  multi- 
plying cells  that  they  not  only  lose  their  power  of  developing  the 
tissue  in  which  they  formerly  lay,  and  have  all  their  vital  powers 
devoted  to  proliferation,  but  they  acquire  the  amoeboid  power  of 
their  ancestors,  the  embryonic  cells,  which  they  further  resemble 
in  size.  Indeed  these  cells  are  freely  spoken  of  as  embryonal 
cells,  and  the  tissue  formed  by  their  massing  together  as  embry- 
onal tissue,  and  there  is  a  widespread  impression  that  they  revert 
entirely  to  the  form  and  characters  of  the  embryonic  cell.  In 
some  respects,  however,  they  are  unlike.  The  modified  tissue 
cell  of  inflammation  presents  a  nucleus  of  horseshoe  outline,  or 
after  division  of  the  nuclei  they  together  retain  this  semi-circular 
outline ;  it  has  the  power  of  actively  digesting  the  adjacent  tis- 
sues as  the  embryonic  cells  do  not,  and  again  it  does  not  possess 
the  power  of  differentiation  into  widely  different  tissues  as  does 
the  early  embryonic  cell.  It  may  be  called  a  reversion,  in  the 
direction  of  the  embryonic  cell,  however,  since  it  reacquires  a 
number  of  its  functions. 

Migration  of  ^vhite  blood  cells.  This  is  another,  and  in  vas- 
cular tissues  the  main  source  of  the  great  cell  accumulation  in  the 
inflamed  tissue.  This  process  was  observed  by  Waller  in  1846, 
but  was  given  its  true  importance  through  the  later  observations 
of  Cohnheim.  The  migration  takes  place  through  the  walls  of 
the  capillaries  and  veins  only,  and  the  migrating  cells  are  largely 
of  the  poly-nuclear  variety  of  leucocytes.  These  remaining  ad- 
herent to  the  inner  wall  of  the  blood  vessel  may  be  seen  to  have 
a  small  portion  of  their  substance  projected  through  the  wall  and 
appearing  as  a  small  buttonlike  projection  on  the  outer  side. 
This  gradually  increases,  while  the  remaining  portion  of  the  cell 
on  the  inner  side  of  the  wall  correspondingly  decreases  until  the 
whole  cell  is  lodged  in  the  tissue  outside  the  vascular  wall.  The 
time  occupied  in  passing  through  is  very  varied.  It  may  be 
wholly  accomplished  in  half  a  minute,  and  again  hours  may  be 
required  for  the  complete  passage  of  a  single  leucocyte.  The  ex- 
planation of  this  migration  has   been    sought   in   the   supposed 


44  Veterinary  Medicine. 

existence  of  stigmata  (openings)  in  the  vascular  walls  (Arnold), 
in  the  effect  of  the  blood  pressure  within  the  inflamed  vessels, 
in  softening  of  the  vascular  walls  and,  in  the  contractility  of  the 
leucoc}' te  which  is  strongl}^  attracted  by  the  pressure  of  certain 
bacteria  and  other  irritants  (chemiotaxis).  The  migrated  leuco- 
cyte assumes  in  the  tissues  the  same  habit  as  the  altered  tissue 
nucleus.  It  multiplies  rapidly,  assists  in  the  solution  and  removal 
of  the  inflamed  tissue,  contests  the  ground  with  infective  microbes 
(phagocytosis),  and  subserves  the  purpose  of  assisting  in  building 
up  new  tissue,  or  of  degenerations. 

Red  Cells.  The  red  blood  globules  follow  the  active  current 
in  the  centre  of  the  blood  vessel,  yet  a  few  of  these  also  become 
adherent  to  the  softened  walls  and  pass  through  them  (diapede- 
sis).  When  stasis  of  blood  takes  place  in  the  vessels,  they  be- 
come packed  more  closely  with  red  globules  which  then  pass  out- 
ward into  the  tissues  in  much  larger  numbers. 

Changes  in  innervation.  As  shown  under  hypersemia  the 
vaso-motor  system  of  nerves  exerts  a  potent  influence  on  the  circu- 
lation and  is  largely  instrumental  in  bringing  about  circulatory 
disorders.  The  increase  in  the  number  and  force  of  the  contrac- 
tions of  the  heart,  and  the  rigid  contraction  of  the  walls  of  the 
arteries  proceeding  to  an  inflamed  part,  are  distinctly  the  result  of 
a  reflex  nervous  action.  The  implication  of  the  second  eye  when 
one  has  been  violently  inflamed  from  a  mechanical  injury  is 
another  example  of  this  kind.  The  loss  of  power  of  the  vaso-mo- 
tor nerves  is  however  even  more  characteristic.  Experimentally 
the  cutting  of  the  cervical  sympathetic  or  crushing  of  the  superior 
cervical  ganglion  causes  congestion  and  finally  inflammation  of 
the  structures  on  that  side  of  the  head  ;  the  crushing  of  the  semi- 
lunar ganglion  similarly  affects  the  abdominal  viscera  ;  and  the 
cutting  of  the  pelvic  plexus,  the  structures  of  the  hind  leg.  The 
contraction  and  dilatation  of  the  inflamed  capillaries  is  largely 
a  nervous  phenomenon.  A  certain  number  of  irritants,  like 
warm  water,  mustard,  or  ammonia  cause  contraction  followed  by 
dilatation  of  the  capillaries,  while  others  like  dilute  mineral  acids, 
alkalies,  chloroform,  or  sodium  chloride  and  sugar  in  concen- 
trated solution  produce  dilatation  at  once.  Some  poisons  act  vari- 
ously on  different  parts,  eucalyptol  causing  dilatation  of  the  arteries 
and  contraction  of  the  veins,  while  corrosive  sublimate  causes  con- 
traction of  the  arteries  and  dilatation  of  the  veins. 


Inflamation.     Plogosis.     Phlegmasia.  45 

So  with  certain  microbian  toxins.  Introduced  into  the  general 
circulation  they  produce  active  congestion  or  inflammation  in  the 
seat  of  colonization  of  the  microbe  from  which  they  were  derived, 
as  witnessed  in  the  use  of  tuberculine  or  mallein.  Finally  the 
chill  and  febrile  reaction  which  attends  on  extensive  inflammation 
is  essentially  a  nervous  phenomena  in  its  inception  and  progress. 

Changes  in  the  circulation.  The  usual  changes  in  the 
bloodvessels  of  the  inflamed  part  may  be  thus  succinctly  stated  : 
I.  Contraction  of  the  capillary  vessels  of  the  affected  part  and 
hastening  of  the  current  of  blood  through  them.  2.  The  suc- 
ceeding dilatation  of  the  capillaries  and  the  slowing  of  the  blood 
stream,  vhich  still  flows  uniformly  throughout  the  diseased  tis- 
sue. 3.  The  flow  of  blood  becomes  irregular,  at  points  tardy, 
and  at  others  oscillating  or  even  recoiling  between  the  pulse  beats 
when  it  has  been  forced  into  a  vessel  already  blocked  by  coagulum. 

4.  In  the  still  pervious  vessels  the  red  blood  globules  occupy  the 
centre  of  the  vessel  where  the  current  is  rapid,  while  the  white 
globules  roll  slowly  along  the  inner  surface  of  the  walls  where 
the  current  is  slow  and  become  adherent  to  the  walls  and  station- 
ary, while  the  general  current  rolls  on.  This  is  a  direct  abstrac- 
tion of  the  white  globules  from  the  circulating  blood  and  greatly 
favors  the  coagulation  of  the  blood  in  the  capillaries.  The  blood 
plates  equally  collect  in  the  periphery  of  the  vessel   and   escape. 

5.  The  adherent  white  globules  migrate  in  large  numbers  through 
the  capillary  and  venous  walls  into  the  tissues.  The  red  globules 
migrate  to  a  less  extent  at  first.  6.  Small  coagula  form  in  the 
affected  capillaries,  forming  minute  red  points  which  cannot  be 
pressed  out  by  the  finger.  7.  The  red  globules  in  the  area  of 
stagnation  back  of  these  capillary  emboli  adhere  to  each  other  by 
their  flat  surfaces  and  form  rolls  which  pack  into  the  vessel  and 
are  enveloped  in  a  fibrinous  clot.  8.  The  liquid  part  of  the  blood 
rapidly  exudes  into  the  tissues  leaving  the  red  globules  relatively 
much  more  abundant  in  the  liquid  which  remains  inside  the  ves- 
sel. 9.  The  walls  of  the  capillaries  become  softened  and  allow  a 
readier  transudation  of  liquor  sanguinous,  and  escape  of  the  glob- 
ules through  the  walls  of  the  vessels.  10.  The  arteries  leading 
to  the  inflamed  part  have  their  muscular  coats  more  rigid  aud  un- 
yielding and  transmit  much  more  blood  than  the  corresponding 
artery  leading  to  the  healthy   part.      11.   The  heart  is  equally 


46  Veterinary  Medicine. 

roused  to  more  rapid  and  often  more  forcible  contractions,  which 
modify  the  pulse  both  in  number  and  rytlim.  12.  The  circulating 
blood  is  found  to  have  received  a  great  increase  in  the  fibrine  for- 
mers, the  fibrine  in  the  shed  blood  amounting  to  6,  8,  or  10  parts 
per  1000  in  place  of  3  parts  as  is  normal.  The  contraction  of 
this  causes  a  depression  on  the  surface  of  the  clot.  13.  The  red 
globules  become  viscous  and  adhere  together  by  their  fiat  surfaces 
to  form  rolls,  which  precipitate  much  more  rapidly  than  single 
globules  and  leave  the  coagulated  blood  with  a  straw-colored  up- 
per stratum  (buffy  coat).  14.  Increase  of  waste  products,  urea, 
uric  acid,  hippuric  acid,  etc. 

Other  changes  in  the  blood  are  alleged,  like  lessening  of  the  al- 
bumen, as  balancing  the  increase  of  fibrine,  and  lipsemia,  but 
the  constancy  of  these  in  all  cases  of  inflammation  is  uncertain. 

By  way  of  comment  and  explanation  of  the  above  changes  in  the 
circulation  the  following  may  be  advanced  :  The  primary  con- 
traction of  the  capillaries  is  by  no  means  a  necessary  condition  of 
inflammation,  and  contractions  and  dilatations  within  certain  lim- 
its occur  in  health  and  as  a  purely  physiological  act.  The  dilata- 
tion of  the  capillaries  and  the  increased  flow  of  blood  to  the  part 
are  related  to  each  other  as  in  part  cause  and  effect,  yet  both  are 
due  to  a  reflex  act  from  the  seat  of  irritation  which  inhibits  con- 
traction in  the  capillaries  and  determines  a  more  rigid  contraction 
in  the  walls  of  the  arteries  running  to  the  part.  A  rigid  inelastic 
vessel  of  the  same  calibre  and  under  the  same  pressure  transmits 
more  liquid  than  the  one  with  elastic  walls.  The  movement  of 
the  white  globules  to  the  walls  of  the  vessel  depends  in  part  on 
their  levity,  light  bodies  passing  into  the  outer  slow  moving  layer, 
which  is  less  dense,  from  the  central  stream  where  the  force  and 
density  are  greater.  The  epithelial  cells  of  the  intima  undergo 
cloudy  swelling  and  are  often  detached,  allowing  the  readier  mi- 
gration of  the  globules  through  the  openings  of  the  lymphatics 
and  the  softened  and  friable  walls.  When  the  capillaries  are 
blocked  the  pressure  necessarily  increases  on  the  arterial  side,  fa- 
voring laceration  of  the  friable  walls  and  the  escape  of  minute 
masses  of  blood.  The  formation  of  the  buffy  coat  is  characteristic 
of  the  normal  equine  blood  ;  in  inflammation  it  becomes  more 
abundant.  In  the  other  genera  a  buffy  coat  apart  from  inflamma- 
tion may  be  shown   in  :   (a)   ansemia  or  oligocythaemia  in  which 


Inflamation.     Plogysis.     Phlegmasia.  47 

the  blood  is  deficient  in  red  globules  ;  (b;  in  plethora  in  which 
there  is  an  excess  of  blood  solids  ;  (c)  in  pregnancy  in  which 
there  is  an  excess  of  white  and  small  red  globules  ;  (d)  in  violent 
exertion  or  over-excitement,  in  which  the  blood  has  circulated 
with  extraordinary  rapidity.  The  all-sufficiency  of  the  tissue 
cells  in  determining  inflammation  may  be  deduced  from  the  fol- 
lowing experiment.  A  ligature  is  tied  around  a  frog's  thigh  so 
tightly  as  to  arrest  circulation,  and  the  leg  amputated  above  the 
ligature  ;  mustard  is  then  applied  to  the  web  of  the  foot  and  a 
blister  ri.ses  precisely  as  though  circulation  continued. 

MICROBES,    DIAPEDESIS    AND    PHAGOCYTOSIS. 

The  role  of  microbes  in  inflammation  is  much  greater  than 
was  formerly  supposed.  It  is  now  demonstrated  that  a  large  class 
of  inflammations  are  directly  caused  by  the  colonization  of  mi- 
crobes in  the  tissue  and  by  the  local  irritation  caused  by  their 
ptomaines  and  toxins.  We  must  also  admit  the  direct  action  of  the 
latter  on  the  heat  producing  and  vaso-motor  nervous  centres,  as 
a  factor  more  or  less  potent  in  different  cases  in  the  causation  and 
maintenance  of  inflammation.  No  less  important  is  the  relation 
of  the  microbe  to  the  migration  of  the  globules  and  the  subsequent 
results  of  the  inflammation.  This  influence  microbes  share  with 
certain  chemical  agents.  Migration  maj^  be  greatly  checked  even 
in  inflamed  parts  by  the  hypodermic  or  intravenous  injection  of 
sulphate  of  quinia,  eucalyptol,  salicylic  acid,  or  iodoform.  Some 
have  thought  these  acted  by  a  chemiotactic  attraction,  but  quinia 
is  otherwise  found  to  repel  the  leucocytes.  Their  action  on  the 
leucocytes  or  capillary  walls  is  problematic. 

Chemiotaxis  is  that  power  by  which  a  microbe  or  any  element 
attracts  or  repels  the  leucocytes.  When  it  attracts  the  chemio- 
taxis is  said  to  be  positive,  when  it  repels  it  is  negative.  Among 
negative  chemiotactic  agents  are  quinia,  solutions  of  sodium  chlo- 
ride (109^),  and  potassium  salts,  lactic  acid,  alcohol  (lo^c),  chlo- 
roform, glycerine,  jequirity,  and  bile.  To  some  agents,  (creatine, 
creatinine,  allantoin,  peptone,  phlorydzine,)  leucocytes  are  indif- 
ferent. To  gluten,  wheat  casein,  pea  legumin  and  the  great 
majority  of  pathogenic  microbes,  leucocytes  are  positively  attract- 
ed.    As  microbes  exercise  a  great  influence  in  producing  local  in- 


^8  Veterinary  Medicine. 

flammation,  so  they  are  important  factors  in  procuring  an  abun- 
dant emigration  of  leucocytes.  Some  of  the  most  fatal  of  micro- 
bian  diseases,  like  fowl  cholera,  repel  leucocytes,  and  the  benefit 
of  their  defensive  work  is  to  a  large  extent  lost.  The  toxins  of 
the  chemiotactic  microbe  filtered  from  the  bacteria  exert  the  same 
influence  as  the  living  bacteria,  as  shown  by  Gabritchevski,  Mas- 
sart  and  Bordet. 

But  chemiotaxis  may  be  exerted  from  within  the  bloodvessel  as 
well  as  from  without.  Bouchard,  Massart  and  Bordet  have  .shown 
that  a  tube  containing  a  culture  of  bacillus  pyocyanus,  introduced 
beneath  the  skin  of  a  rabbit  attracts  in  a  few  houi-s  a  great  num- 
ber of  leucocytes.  But  if,  immediately  after  its  introduction,  ten 
cubic  centimetres  of  a  sterilized  culture  of  the  same  bacillus  are 
injected  into  a  vein,  very  few  leucocytes  enter  the  tube  inserted 
under  the  skin.  The  chemiotaxis  seems  to  operate  in  this  case 
from  within  the  blood,  and  the  desires  of  the  leucocytes  are  satis- 
fied without  leaving  the  vessel.  It  would  seem  that  in  such  cases 
the  migration  and  protective  work  of  the  leucocytes  is  best  ex- 
erted at  the  outset  of  the  illness  and  before  the  toxic  products 
have  been  poured  into  the  blood  in  any  quantity,  whereas  in  the 
advanced  stages  when  the  blood  is  charged  with  ptomaines  and 
toxins  migration  and  phagocytosis  would  be  likely  to  be  limited 
and  ineffective.  The  same  consideration  would  forbid  the  use  of 
drugs  that  check  migration  in  all  cases  of  attacks  by  microbes  for 
which  leucocytes  have  a  positive  chemiotaxis. 

Phagocytosis  is  the  act  by  which  the  leucocytes  englobe  and 
dissolve  the  invading  microbe.  By  its  amoeboid  movement  the 
leucocyte  flows  around,  and  envelopes  the  microbe  for  which  it  has 
a  positive  chemiotaxis,  and  then  begins  the  struggle  of  vitality 
between  the  two  living  germs.  If  the  poison  (leucomaine  anti- 
toxin,) and  digestive  ferment  (enzyme)  of  the  leucocytes  are 
more  deadly  to  the  invading  germ,  than  its  ptomaines,  toxins  and 
enzymes  are  to  the  leucocyte,  the  white  cell  comes  off  the  victor, 
and  recovery  takes  place,  but  if  the  converse  obtains  the  triumph 
is  on  the  side  of  the  microbe.  As  a  rule  much  depends  on  the 
more  or  less  deadly  nature  of  the  products  of  the  invading  mi- 
crobe, on  the  numbers  of  the  germ,  the  rapidity  of  its  prolifera- 
tion, and  the  consequent  amount  of  its  toxic  products  thrown  into 
the  system,  on  the  one  hand  :  And  on  the  other  the  potency  of 


Inflamation.     P/ogosis.     Phlegmasia.  49 

the  chemiotaxis  of  the  leucocyte  for  the  invading  germ,  the  num- 
ber of  white  cells  that  emigrate  into  the  inflamed  tissue  and  en- 
gage in  the  work  of  phagocytosis,  and  on  whether  the  particular 
animal  system  and  its  white  cells  have  sustained  a  previous  at- 
tack by  the  same  germ  and  has  thereby  been  educated  to  produce 
a  greater  amount  of  the  defensiv^e  proteids  (leucomaine,  anti- 
toxin, enzyme)  than  it  naturally  would  (acquired  immunity). 

Even  with  an  abundant  emigration  of  the  leucocytes  into  the 
inflamed  or  invaded  tissue,  a  number,  greater  or  less,  are  usually 
destroyed  by  the  bacterial  poisons  and  pass  into  degeneration  or 
liquefaction,  as  in  the  formation  of  pus,  and  yet  the  attacking  germ 
may  be  overcome,  destroyed  and  devoured  by  the  rapidly  increas- 
ing survivors.  In  general  terms  the  migration  of  the  cells  is  in 
inverse  ratio  to  the  susceptibility  of  the  animal  to  the  microbe  or 
the  disease  which  it  causes. 

The  positive  and  negative  chemiotaxis,  which  determine  phago- 
cytosis or  prevent  it,  may  be  seen  in  the  action  of  the  leucocytes 
toward  the  germs  of  two  diseases,  to  one  of  which  the  animal  is 
susceptible  and  to  the  other  of  which  it  is  not.  Thus  the  leuco- 
cytes of  the  pigeon  take  in  the  bacillus  anthracis  and  suffer  noth- 
ing apparently,  whereas  the  same  white  cells  of  the  dove  are  re- 
pelled by  the  bacteria  of  fowl  cholera  which  are  not  therefore 
found  in  their  interior. 

The  leucocytes  that  migrate  from  the  bloodvessels  are  in  the 
main,  the  most  numerous,  (the  neutrophile  or  polynuclear)  form  ; 
the  mononuclear  leucocytes  with  horseshoe  shaped  nucleus  also 
migrate  but  in  much  fewer  numbers  and  are  as  a  rule  less  oc- 
cupied in  phagocytosis.  At  the  same  time,  these  two  forms  may 
show  each  a  preference  for  a  particular  microbe,  the  polynuclear 
cell  sometimes  devouring  one  which  the  mononuclear  cell  rejects, 
and  the  mononuclear  cell  taking  in  one  which  the  polynuclear  re-- 
fuses. 

The  small  round  white  cells  (lymphocytes)  and  the  eosinophile 
leucocytes  take  no  prominent  part  in  phagocytosis. 

EXUDATION. 

In  inflamed  vascular  tissues  one  of  the  most  important  results 
is  the  exudation.     This  is  not,  however,  a  mere  transudation  of 


50  Veterinary  Medicine. 

the  liquid  parts  of  the  blood,  as  takes  place  in  drops)',  but  it  is  to 
a  large  extent  a  selective  process  determined  apparently  by  the 
condition  of  the  capillary  walls,  and  the  nature  of  the  inflamma- 
tion is  stated  according  to  the  character  of  the  exudate.  The 
dropsical  effusion  contains  little  albumen,  fibrine  or  cell  forms, 
and  does  not  coagulate.  The  inflammation  exudate  contains 
abundance  of  fibrine,  cells  and  other  solids  and  coagulates  spon- 
taneously in  contact  with  inflamed  tissue,  or  when  removed  from 
ths  body,  by  reason  of  th2  transforming  leucocytes.  Inflamma- 
tory exudate  usually  contains  6  to  8  per  cent,  of  solids  whereas 
the  normal  canine  lymph  contains  4  to  6.  The  exudate  varies 
not  only  in  different  inflammations,  but  in  successive  stages  of 
the  same  inflammation.  The  exudate  may  be  mucous,  .serous, 
fibrinous  or  hsemorrhagic. 

Mucous  Exudate.  In  inflammation  on  a  mucous  or  synovial 
surface  the  inflammatory  exudation,  mingled  with  the  more  or 
less  altered  secretion  of  the  mucous  glands,  and  the  epithelial  cells 
and  leucocytes  forms  a  viscid  fluid,  rich  in  mucin,  and  character- 
izing the  mucous  or  catarrhal  inflammation.  The  nature  of  the 
discharge  varies  greatly,  the  serous  character  predominating  at 
the  start  of  the  inflammation,  and  a  thick,  opaque  creamy  or  semi- 
solid muco-purulent  material  appearing  as  the  disease  advances. 
It  contains  filaments  of  precipitated  mucin  insoluble  in  acetic 
acid  or  alcohol  and  cells  in  all  stages  of  change  from  the  exuda- 
tion leucocyte  and  mucous  cell  to  the  pus  corpuscle,  the  latter  be- 
ing characterized  by  its  bipartite  or  tripartite  nucleus  rendered  vis- 
ible by  contact  with  weak  acetic  acid. 

Serous  Exudate.  This  consists  of  the  liquid  elements  of  the 
blood  with  only  a  limited  amount  of  fibrine  formers  and  conse- 
quently little  tendency  to  clot  firmly.  The  presence  of  fibrinogen 
however  serves  to  distinguish  it  from  the  liquid  of  mechanical 
dropsy,  as  does  also  the  greater  quantity  of  cells  and  nuclei  of 
common  salt  and  phosphates.  It  is  usually  straw  colored  in 
mass,  but  is  sometimes  slightly  opalescent  by  reason  of  the  num- 
bers of  cells  and  floating  filaments  of  fibrine.  Serous  exudations 
take  place  in  the  early  stages  of  inflammations  (as  in  catarrh)  and 
in  inflammations  of  serous  membranes  (pleura,  peritoneum, 
joints),  in  strong,  vigorous  subjects.  They  constitute  the  liquid 
contents  of  blisters  whether  raised  by  medicinal  irritants,  chafing, 


Inflamatio7i.     Plogosis.     Phlegmasia.  51 

or  heat.     They  clot   under  heat  and   nitric  acid  with  a  firmness 
proportionate  to  the  amount  of  albumen. 

These  effusions  are  dangerous  by  reason  of  their  interference 
with  the  functions  of  organs  by  pressure  as  with  the  dilatation  of 
the  lungs,  the  movements  of  the  heart,  the  action  of  joints,  or  the 
integrity  of  the  brain  or  spinal  cord.  When  the  causative  disease 
has  subsided  they  are  usually  speedily  reabsorbed,  the  cells  pas- 
sing into  the  lymph  vessels,  or  becoming  degenerated,  liquefied, 
and  absorbed.  Yet  serous  effusions  often  remain  as  permanent  ac- 
cumulations. For  the  blood  staining  of  serous  effusions  and  their 
clearing  up,  see  under  pleurisy. 

Fibrinous  Exudate.  This  is  characterized  by  the  amount  of 
fibrinogen  and  fibro-plastin  in  its  composition  and  by  the  compar- 
ative absence  of  leucocytes.  It  oozes  through  the  vessels  and  co- 
agulates in  the  tissues  or  on  the  surface  of  inflamed  serous  or  mu- 
cous membranes.  The  more  liquid  part  separating  from  the  co- 
agulum  escapes  from  the  free  surface  or  accumulates  in  the  lower 
part  of  the  serous  cavity.  The  coagulation  is  doubtless  caused 
by  the  fibrine  ferment  derived  from  the  rapidly  proliferating  cells 
and  degenerating  leucocytes.  It  usually  occurs  promptly  in  or 
on  an  inflamed  tissue,  but  in  contact  with  healthy  structures  only 
(as  in  a  serous  sac)  it  may  remain  fluid  for  an  indefinite  length 
of  time.  This  exudate  constitutes  the  false  membranes  that  form 
on  the  pleura,  pericardium  or  arachnoid,  the  coagulum  of  fibrin- 
ous pneumonia,  and  the  plastic  lymph  on  the  surface  of  a  granu- 
lating wound.  It  is  especially  injurious  by  reason  of  its  envelop- 
ing organs  (lungs,  heart,  bowels,  iris)  and  subjecting  to  perma- 
nent compression  by  reason  of  its  contracting,  also  by  binding 
them  to  adjacent  structures  by  false  membranes.  In  coagulating 
it  becomes  first  fibrillar  then  granular  and  finally  undergoes  mo- 
lecular degeneration  (Cornil  and  Remvier),  or  development  into 
new  tissue  (Paget).  When  organized  it  usually  takes  the  form 
of  the  adjacent  tissue  from  which  its  trophic  cells  are  derived. 
Thus  in  divided  tendons,  in  serous  membranes  and  in  granu- 
lating wounds  it  is  fibrous,  and  between  the  ends  of  a  broken  bone 
it  is  osseous.  If  however,  the  adjoining  tissue  is  a  highly  organ- 
ized one,  like  nerve  or  muscle  it  may  be  replaced  by  a  simpler 
(fibrous,  osseous). 

Fibrinous   inflammations  are   especially    found    in    connection 
with  inflamed  fibrous  tissues  and  in  strong  vigorous  subjects. 


52  Veterinary  Medicine. 

Blood  Exudations.  In  all  inflammations  there  is  some  mi- 
gration of  blood  globules  (red  as  well  as  white)  but  seldom  in 
quantity  sufficient  to  stain  the  tissues  materially.  Minute  ruptures 
of  the  capillary  vessels  are  not  uncommon,  with  punctiform  clots 
in  the  tissues,  but  extensive  escape  of  blood  is  mainly  seen  in 
penetrating  or  contused  wounds  of  the  loose,  subcutaneous  con- 
nective tissue,  and  in  infective  inflammations  (anthrax,  Rinder- 
pest, swine  plague,  petechial  fever,  malignant  catarrh,  snake- 
bites) with  destruction  of  blood  globules  or  extreme  changes  in 
the  walls  of  the  capillaries.  Newly  formed  vessels  in  friable  neo- 
plasm are  subject  to  blood  effusions.  In  acute  inflammations  of 
serous  membranes  the  exudate  is  usually  of  a  dark  port  wine  hue 
at  first.  In  such  cases  it  may  pass  in  succession  through  all  the 
stages  of  dark  red,  brick  red,  yellow,  reddish,  and  chocolate  color, 
before  becoming  milky  and  finally  transpareut. 

Croupous  Exudate.  Croupous  inflammation  usually  occurs  on 
or  near  a  mucous  surface  and  is  characterized  by  an  exudation 
consisting  mainly  of  fibrinous  material  entangling  white  cells, 
epithelium,  a  few  pus  corpuscles  and  some  form  of  bacteria.  In 
true  diphtheria  of  children  this  is  the  Loffler  bacillus,  in  the  pseudo- 
diphtheria,  attending  on  scarlatina,  etc.,  it  is  streptococcus  pyoge- 
nus,  in  the  diphtheria  of  calves  it  is  bacillus  diphtherise  vitulorum, 
and  in  that  of  chickens  and  pigeons  it  is  the  bacillus  diphtheriae  col- 
umbarum  (Ivoffler).  Pseudomembranous  inflammations  therefore 
constitute  a  group  agreeing  in  the  nature  of  the  exudate  but 
differing  essentially  in  the  cause.  This  difference  in  the  cause 
has  a  most  material  effect  on  the  course  and  gravity  of  the  disease. 
One  form  like  true  diphtheria  in  man  not  only  extends  into  the 
tissues,  and  tends  to  necrotic  changes,  but  also  poisons  the  nerve 
centres  by  the  toxic  materials  absorbed  inducing  troublesome 
paralysis,  while  another  like  croup  of  children  establishes  a  vio- 
lent but  essentially  superficial  disease  and  when  that  recovers  it 
leaves  no  ulterior  ill  effects  elsewhere. 

A  Chyliform  exudate  has  been  noted  in  peritonitis  in  the  dog 
the  milky  whiteness  being  due  to  fatty  granules. 

RESULTS   AND   PRODUCTS   OF   INFLAMMATION. 

As  nearly  all  inflammations  have  significant  exudations  it  is 
well  to  follow  these  in  their  subsequent  progress  through  reab- 


Inflamation.     Plogosis.     Phlegmasia.  53 

sorption  and  removal,  development  into  new  tissues,  necrosis, 
suppuration  and  ulceration. 

Resolution.  If  an  inflammation,  slight  in  character  and  with 
only  a  moderate  exudation,  subsides  and  is  followed  by  a  rapid 
liquefaction  of  the  cells  and  fibrinous  coagula  and  a  reabsorption 
of  the  exudate,  so  as  to  leave  the  part  in  its  primary  healthy  con- 
dition structurally  and  functionally,  it  is  said  to  have  terminated 
by  "  resolution.''  If  this  occurs  with  extraordinary  rapidity  it  is 
said  to  have  ended  by  ' '  delitesceyice. ' '  This  is  not  always  an  unal- 
loyed good,  as  often  in  delitescence,  coagula  and  infecting  material 
ma}^  be  carried  on  by  the  circulation,  to  block  the  next  set  of 
capillaries  in  its  course  and  set  up  new  centres  of  inflammation. 
This  is  one  form  of  ' '  metastasis'' '  though  a  more  definite  metasta- 
sis is  in  rheumatism  where  the  disease  attacks  one  joint  to-day 
and  a  distant  one  to-morrow. 

Inflammatory  New  Formations.  Of  the  growths  in  lymph 
there  are  two  principal  kinds  :  first,  the  plastic,  fibrinous,  granu- 
lar or  inolecidar  /  and  second,  the  aplastic  or  corpuscular.  The 
first  form  tends  to  develop  into  new  structure,  the  second  to  dis- 
integrate and  decay.  The  tendency  to  one  or  other  form  depends 
largely  on  the  strength  or  weakness  of  the  system's  health,  on  the 
deficiency  or  excess  of  corpuscles  in  the  exuded  fluid,  and  on  the 
distance  of  the  latter  from  living  tissues  and  blood  supply.  Much 
also  depends  on  the  predisposition  of  the  genus,  the  tendency  to 
suppuration  in  lymph  being  in  a  descending  series  from  horse,  ass, 
and  mule,  through  ox  and  .sheep,  to  dog,  pig,  and  finally,  the 
bird,  in  which  latter  suppuration  is  quite  exceptional. 

Suppuration.  In  inflammations  of  a  high  type,  in  those  oc- 
curring on  the  skin  or  mucous  membranes  in  which  there  is  an 
extraordinary  increase  of  nuclei  and  embryonal  cells,  and  in  lymph 
thrown  out  in  excess  at  one  point,  so  that  its  central  parts  are  far 
from  vascular  tissue  and  nourishment,  the  cell  elements  undergo 
a  rapid  increase  and  degradation  into  pus-corpuscles,  and  its  solid- 
ified intercellular  Ij'mph  undergoes  granular  decay  and  liquefaction 
into  pus 

While  the  above  conditions  are  favorable  to  the  formation  of 
pus,  the  process  of  suppuration  must  now  be  recognized  as  an  in- 
fective process  due  to  the  propogation  of  bacteria  (mainly  chain 
forms — Streptococcus  pyogenes — cluster  groups — Staphylococcus  py^ 


54  Veterinary  Medicine. 

ogenes — and  rod  forms — Bacillus  pyogenes).  These  or  other  bac- 
teria are  found  in  the  pus  of  acute  abscesses,  and  when  absent  in 
chronic  abscesses  are  to  be  considered  as  having  perished  since 
the  abscess  was  recent  and  active.  Inoculation  of  a  rabbit  with 
an  excess  of  the  pus  of  an  acute  abscess  produces  general  puru- 
lent infection  (pyaemia)  and  early  death  ;  from  a  medium  dose  an 
abscess  is  produced  ;  while  from  a  small  dose  there  is  no  effect 
whatever.  In  the  latter  case  the  bacteria  are  overcome  and  de- 
voured by  the  abundance  of  vitally  potent  white  blood-globules 
and  tissue  cells.  This  pus-forming  action  of  these  bacteria  ex- 
plains the  great  difference  in  results  in  wounds  exposed  to  the  air 
and  those  in  the  interior  of  the  body  and  far  removed  from  air  and 
its  floating  bacteria.  A  broken  bone,  with  no  wound  in  the  skin 
and  little  injury  to  parts  around  the-  fracture,  is  readily  repaired 
without  any  formation  of  pus,  if  merely  kept  still  and  immova- 
ble ;  whereas  a  broken  bone,  continuous  with  a  wound  through 
the  skin,  always  tends  to  form  pus  or  become  otherwise  infected, 
and  is  extremely  dangerous  even  to  life.  The  tendency  of  every 
open  sore  is  to  form  pus  on  its  surface  but  this  may  be  arrested 
and  avoided  by  preventing  the  access  of  germs,  or  by  a  free 
use  of  disinfectants  aiid  a  covering  which  shall  arrest  and  filter 
out  the  germs.  Similarly  in  an  abscess,  evacuation  followed  by 
the  injection  of  disinfectants,  without  the  formation  of  any  per- 
ceptible permanent  opening  to  the  outer  air,  will  put  a  stop  to  the 
pus-formation.  The  subjection  of  an  inflamed  part  to  the  control 
of  tliese  pus-forming  bacteria  is  dependent  on  the  lowered  vitality 
and  power  of  resistance  of  the  inflamed  tissues,  and  of  the  white 
cells  of  their  circulating  blood.'  Healthy  parts  can  successfully 
resist  them,  though  they  are  constantly  present  in  surrounding 
air  and  on  objects,  but  in  this  as  in  all  other  cases,  of  bacterial 
infection,  so  soon  as  the  tissue  is  injured,  inflamed  and  lowered 
in  its  power  of  vital  resistance,  the  pyogenic  bacteria  assail  it  suc- 
cessfully. Hence,  too,  the  more  abundant  exudations  of  lymph, 
the  centres  of  which  are  farthest  removed  from  the  healthy  tissues 
and  from  nourishment,  are  the  most  prone  to  suppuration.  That 
the  germs  can  make  their  way  to  such  deep-seated  exudations  in 
the  substance  of  solid  tissues  is  to  be  accounted  for  by  their  grad- 
ual advance  through  the  inflamed  and  weakened  structures  from 
the  adjacent  skin  or  mucous  membrane,  or  in  some  instances  by 


Lifiamation.     Plogosis.     Phlegmasia.  55 

reason  of  their  presence  in  small  numbers  in  the  blood.  It  is 
further  noteworthy  that  those  animals  in  which  suppuration  does 
not  occur  readily  are  such  as  have  a  special  power  of  resistance 
to  some  other  organic  poisons.  Thus  the  hog,  which  is  supposed 
to  be  proof  against  snake-bite,  is  also,  to  a  large  extent,  proof 
against  the  pus-forming  bacteria. 

Pus.  This  is  a  white,  or  yellowish-white,  creamy-looking 
product,  composed  of  a  clear,  transparent  fluid,  rendered  opaque 
by  numerous  floating  pus-corpuscles.  These  pus-corpuscles  have 
the  same  size  as  the  white  globules  of  the  blood  (a-jVo^  to  3-roTr 
inch)  and  are  peculiar  in  that  each  shows  within  it  three  or  more 
nuclei,  which  become  visible  on  the  addition  of  a  drop  of  water 
or  acetic  acid.  Each  of  the  common  embryonal  cells  found  in 
the  inflamed  tissue  usually  contains  two  nuclei,  the  indication  of 
the  active  increase  by  division  into  two,  but  when  the  supply  of 
nutriment  is  checked  the  nuclei  continue  to  divide,  while  the 
cells  remain  unchanged,  and  thus  every  cell  comes  to  contain 
several  nuclei  in  addition  to  fatty  granules,  and  constitute  pus- 
corpuscles. 

When  pus  is  formed  in  a  well-maintained  system  and  tissue, 
the  outer  layer  of  the  lymph  is  developed '  into  a  fibrous  sac  in- 
closing the  liquid  pus  and  constituting  an  abscess.  In  an  un- 
healthy system,  or  when  "the  inflammation  depends  on  some 
injurious  poison,  like  that  of  erysipelas,  this  sac  may  not  be 
formed,  and  the  pus,  burrowing  into  and  between  different 
organs,  destroys  the  connections  and  substance — diffuse  siippiira- 
tion.  When  an  abscess  has  formed  in  soft  tissues  its  investing 
sac  shrinks  as  it  assumes  the  fibrous  character,  and  the  confined 
pus  being  incapable  of  compression,  presses  the  membrane  out- 
ward on  the  side  in  which  the  surrounding  tissues  are  most  loose 
and  least  resistant,  hence,  usually,  though  not  always,  in  the 
direction  of  the  skin  ;  the  soft  tissues  become  absorbed  and  re- 
moved in  the  track  of  the  advancing  pus  ;  and,  finally,  the  latter 
reaches  a  free  surface  and  escapes.  Thus,  an  abscess  usually 
bursts  through  the  skin,  but  also,  at  times,  through  a  mucous 
membrane  into  the  lungs,  bowels,  etc.,  or  through  a  serous  mem- 
brane into  chest,  abdomen,  etc.  When  an  abscess  is  formed  in 
bone  or  dense  fibrous  tissues  which  press  equally  on  all  sides,  it 
may  remain  imprisoned  for  months  and  years  after  all  inflamma- 


56  Veterinary  Medicine. 

tion  has  subsided,  constituting  an  indolent  or  cold  abscess.  When 
the  imprisoned  pus  is  inclosed  by  thick  fibrous  or  resistant  tissues 
at  all  points  but  one,  it  will  make  its  way  along  the  narrow  pas- 
sage of  yielding  tissue,  but  as  the  resulting  outlet  is  constricted, 
long,  and  tortuous,  the  contents  cannot  readily  escape  through  it 
nor  the  walls  of  the  abscess  contract  so  as  to  expel  the  confined 
pus,  and  the  latter  goes  on  forming  and  discharging  through  the 
narrow  outlet  for  months  or  years.     This  is  a  fistula  or  sinus. 

Healing  by  Adhesion  or  First  Intention.  When  a  clean- 
cut  wound  has  the  blood  staunched  and  its  lips  brought  together 
without  exposure  to  the  air  (or  contact  with  pyogenic  germs), 
they  adhere  at  once  and  heal  without  pus  or  almost  any  apprecia- 
ble formation  of  new  tissue.  Here  the  lymph  thrown  out  on  the 
cut  surfaces  agglutinates  them,  and  the  cells,  multiplying,  form  a 
thin  layer  of  embryonic  tissue  which  gradually  develops  into  a 
fibrous  structure  and  repairs  the  breach  without  any  perceptible 
scar. 

Healing  by  Second  Intention.  Granulation.  When  a 
wound  has  caused  destruction  of  tissue,  or  when  a  simple  incision 
is  left  exposed  to  the  air,  the  breach  is  filled  up  by  new  tissue 
through  the  process  known  as  granulation.  The  superficial  layer 
of  lymph  thrown  out  on  the  raw  surface  becomes  oxidized  and 
degenerates  into  pus,  while  the  deeper  layers  become  solid,  fibril- 
lated,  the  seat  of  cell-growth,  and  are  finally  transformed  into  a 
fibrous  structure.  New  blood-vessels  form  in  loops  in  the  devel- 
oping lymph  and  constitute  the  bright-red  granulation-points 
which  cover  the  raw  surface.  The  fibrous  tissue  into  which  the 
lymph  is  transformed  undergoes  gradual  contraction  in  develop- 
ment, and  thus,  day  by  day,  the  edges  of  the  adjacent  healthy 
skin  are  drawn  in.  so  as  to  cover  the  wound  more  or  less  per- 
fectly, and  a  slight  scar  only  is  left  when  healing  has  been 
accomplished. 

Granule  Corpuscles  and  Masses.  This  is  another  de- 
generative transformation  in  lymph  and,  is  seen  mainly  in  in- 
flamed glands  and  brain  and  lung-tissue.  The  cells  found  in  the 
exuded  lymph  are  made  up  of  granules  t¥to¥  i^^^h  in  diameter, 
and  besides  these,  large,  irregularly  shaped  masses  of  granules 
are  extended  along  the  capillary  blood-vessels.  After  the  lymph 
has  coagulated  these  granular  masses  soften  and  liquefy   prelimi- 


InflamatioJi.     Ploq^osis.     PJilegmasia.  57 

nary  to  re-absorption  and  removal,  and  the  restoration  of  the  tis- 
sue to  a  healthy  condition.  When  in  excess  this  softens  and  dis- 
integrates the  tissues,  leading  to  permanent  loss  of  substance. 
S&& graimlar  degeneration. 

Interstitial  Development  of  Lymph  into  Tissue.  This 
is  equivalent  to  what  takes  place  in  the  formation  of  the  sac  of 
the  abscess  or  of  granulation-tissue.  The  liquid  lymph  in  coagu- 
lating, becomes  fibrillar,  and  the  cells  and  nuclei  of  the  adjacent 
tissue,  having  an  abundant  supply  of  blood  and  nutriment,  multi- 
ply first  as  simple,  rounded  embryonic  cells,  then  deposit  around 
them  new  tissue,  becoming  elongated,  spindle-shaped,  branching, 
etc. ,  and  thus  get  imbedded  in  a  fibrous  material  of  their  own 
formation.  These  new  formations  are  usually  of  a  low  type  of 
organization,  like  white  fibrous  tissue  or  bone,  and  hence,  al- 
though breaches  in  the  higher  structures  like  muscle,  nerve,  gland, 
skin,  are  filled  up,  it  is  usually  only  by  the  drawing  together  of 
the  remaining  healthy  parts  by  these  new  formations  without  the 
restoration  of  any  of  the  original  tissue  which  has  been  destroyed. 
The  cicatrix  (scar),  alone  is  made  up  of  new  material. 

Lymph  developing  in  this  way  may  undergo  any  degeneration 
to  which  normal  tissues  are  subject.  Thus  it  may  undergo  black 
pigmentary  (jnelanotic)  degeneration,  it  may  become  impregna- 
ted with  lime-salts  (^calcified),  it  may  wither  up  into  a  hard  gcla- 
tiniform  or  Jiorny  mass,  or  it  may  undergo /«//)'  degeneration. 

Fatty  degeneration  is  the  most  common  form,  and  consists  in 
the  excessive  deposit  of  fatty  granules,  first  in  the  cells  which 
are  in  excess  or  badly  nourished,  and  next  in  the  adjacent  tissue, 
the  normal  elements  of  which  are  replaced  by  fatty  granules. 

Softening  is  an  almost  constant  result  of  inflammation.  The 
exudate  infiltrates  and  separates  the  tissue  elements,  destroying 
their  cohesion  ;  the  liquefaction  of  these  elements  impairs  this 
still  further,  and  the  more  or  less  perfect  transformation  of  the 
tissue  into  embryonic  tissue  entails  the  loss  of  its  rigidity  and 
power  of  resistance.  Thus  the  inflamed  brain-tissue  may  become 
a  mere  pulp,  and  the  inflamed  bone  may  be  cut  with  a  knife. 

Ulceration  is  closely  allied  to  softening.  On  the  surface  of  a 
sore  there  is  an  excessive  exudation  of  l3miph,  which  loosens  and 
disintegrates  the  layer  of  lymph  that  is  already  in  process  of  de- 
velopment, and  also  a  part  of  the  tissue  beneath.     The  cells  in 


58  Veterinary  Medicine. 

thsse  parts  fail  to  develop  naturally  and  to  build  up  good  tissue  ; 
they  become  fatty,  die,  and  together  with  the  tissue  in  which 
they  lie,  break  down  and  pass  off  as  a  pulpy  debris.  Thus  the 
sore  constantly  deepens  and  widens,  or  at  least  refuses  to  contract 
and  heal.     It  is  usually  the  result  of  bacterial  infection. 

Gangrene  or  death  of  a  part  is  another  effect  of  inflammation. 
It  results  usually  from  the  cutting  off  of  the  blood-supply  through 
the  obstruction  of  the  blood-vessels  ;  by  the  pressure  of  excessive 
exudation  in  unyielding  structures,  as  in  bone,  or  under  the  hoof  ; 
by  implication  of  the  inner  coats  of  the  blood-vessels  in  the  in- 
flammation, when  the  contained  blood  will  clot  and  obstruct 
them  ;  or  by  blocking  with  the  blood-clots  that  have  been  formed 
at  a  distance  and  washed  on  in  the  blood-current  to  be  arrested 
when  they  reach  vessels  too  small  to  admit  them.  lyike  suppura- 
tion, gangrene  is  associated  with  and  often  caused  by  a  bacterial 
growth.  The  dead  mass  remains  as  an  irritant,  and  is  slowly 
separated  by  the  formation  around  it  of  embryonal  tissue,  granu- 
lations and  pus.  A  second  form  is  molccnlar gangrene,  in  which 
the  cells  and  minute  elements  of  the  tissue  die,  and  are  cast  off, 
leading  to  phagedenic  (eating,  extending)  sores,  as  noted  above 
under  Ulceration.  When  gangrene  occurs  on  an  exposed  surface, 
that  may  be  altered  from  the  normal  color  into  shades  of  yellow, 
brown,  green,  red,  or  black,  according  to  the  amount  of  blood  and 
the  stage  of  decomposition,  and  may  be  cut  without  pain,  if  the 
subjacent  parts  are  not  pressed  upon  ;  it  may  be  soft,  may  pit  on 
pressure,  may  crackle  under  the  hand  from  the  evolved  gases  of 
decomposition,  and  may  be  covered  with  blisters  (^phlyctenai)  with 
red,  grumous  liquid  contents  {inoist gangrened  ;  again,  it  may  be 
white,  as  after  freezing,  or  it  may  be  dark-colored,  dry,  and 
horny,  as  from  ergoti.sm  {dry  gangrene^. 


FEVER. 

Definition.  Symptomatic.  Idiopathic.  Symptoms.  Contagion.  Incu- 
bation. Premonitory  symptoms.  Chill,  rigor.  Reaction,  hot  stage.  De- 
fervescence. Crisis.  I/ysis.  Natural  temperature.  Fever  temperature. 
Retention  of  water  in  the  system.  Production  of  waste  materials.  Typhoid 
condition.  High  fever,  low,  hectic.  Treatment  in  vigorous  subject,  in 
weak  one.  Regimen.  Solipedes.  Ruminants.  Carnivora.  Drink.  Rest. 
Clothing.  Air.  General  and  local  bleeding.  Cupping.  Warm  baths, 
tepid,  compresses,  derivatives.  Cold.  Diaphoretics.  Laxatives.  Diuret- 
ics. Sedatives.  Alkalies.  Antipyretics.  Stimulants.  Tonic  refrigerants. 
Tonics.  In  low  fever.  No  depletion.  Judicious  elimination.  Stimulants. 
Refrigerants.  Antiseptics.  Diet.  Local  treatment  of  inflammation.  Cold. 
Astringents.  Antiseptics.  Warm  applications.  Stimulating  embrocations. 
Blisters.     Firing.     Massage.     Suppuration. 

Definition.  Whether  occurring  as  an  accompaniment  of  in- 
flammation or  independently  of  it,  fever  is  an  unnatiiral  elevation 
of  the  temperature  of  the  body,  the  direct  result  of  an  excess  of 
destructive  chemical  change  in  the  blood  and  tissues,  and  more  re- 
motely of  disordered  nervous  function. 

Of  all  extensive  inflammations  fever  is  the  constant  result  and 
accompaniment,  rising  as  the  inflammation  rises  or  extends,  and 
subsiding  as  the  inflammation  .sitbsides.  It  also  occurs  as  a  dis- 
tinct affection,  as  in  all  the  infectious  diseases,  as  the  result  of  a 
specific  irritating  poison  in  the  sj'stem,  and  then  is  the  manifesta- 
tion of  the  disease,  while  a  local  inflammation  may  or  may  not  be 
present  as  a  special  secondary  feature  of  the  malady  or  as  an  ac- 
cidental complication. 

Symptoms  of  Fever.  Fever  is  marked  by  certain  definite  stages, 
each  of  which  has  its  own  special  manifestations.  In  the  cases 
due  to  a  specific  disease-germ,  or  contagium,  the.se  are,  however, 
preceded  by  a  period  of  latency  or  incubation  in  which  no  symp- 
toms whatever  are  manifest,  but  during  this  time  the  germ  is 
rapidly  multiplying  in  the  .sy.stem,  and  it  is  only  when  it  has 
gained  a  certain  increase  that  it  disorders  the  nervous  system, 
wastes  the  ti.ssues,  raises  the  temperature  of  the  bodj^  and  induces 
the  other  phenomena  of  fever.  The  same  may  be  said  to  hold  in 
the  fever  attending  on  inflammation.       The  slight  and  circum- 

59 


6o  Veterinary  Medicine. 

scribed  inflammation  is  at  first  productive  of  no  fever,  and  it  is 
only  when  it  gains  a  certain  extent  that  the  nerves  and  nutrition 
are  disordered  so  as  to  bring  about  a  feverish  condition. 

Premonitory  Symptoms.  These  usually  last  but  a  few  hours 
and  are  often  entirely  absent  or  unnoticed.  There  is  a  lack  of 
the  customary  vigor  and  spirit,  an  indisposition  to  exertion,  a  loss 
of  clearness  and  vivacity  of  the  eye,  a  manifest  dullness,  with 
hanging  of  the  head,  and  frequent  shifting  of  the  limbs  as  if 
fatigued.  Appetite  is  less  sharp  and  ruminants  chew  the  cud  less 
heartily  or  persistently. 

Cold  Stage.  These  are  soon  succeeded  by  the  chill,  rigor,  or 
shivering  fit,  in  which  the  hair,  especially  that  along  the  back, 
stands  erect  (staring  coat),  the  skin  is  cold  and  adherent  to  the 
structures  beneath  (hidebound),  the  extremities  (legs,  tail,  ears, 
horns,  nose)  are  cold,  and  the  frame  is  agitated  with  slight  tremors, 
or  even  a  shivering  so  violent  that  a  wooden  floor  or  building  is 
made  to  rattle.  The  back  is  arched,  the  legs  brought  nearer  togeth- 
er (crouching),  the  mouth  is  cool  and  clammy,  the  breathing  hur- 
ried, the  pulse  weak,  and  it  may  be  rapid,  but  with  a  hard  beat, 
the  bowels  costive,  and  the  urine  higher  colored  than  natural. 
The  temperature  of  the  interior  of  the  body,  taken  by  a  thermo- 
meter in  the  rectum,  is  already  found  above  the  normal,  the  ex- 
cessive destruction  of  tissue  having  begun,  and  the  blood  driven 
from  the  cooler  surface,  and  accumulating  in  the  hot  interior,  at 
once  favors  tissue-change  and  maintains  the  extra  heat  thereby 
produced.  In  cattle  the  end  of  the  tail  is  soft  and  flaccid  from 
this  stage  onward.  The  cold  stage  lasts  a  few  minutes,  or  one  or 
two  days  in  different  cases. 

Hot  Stage.  The  hot  stage  appears  as  a  reaction  from  the  chill, 
the  contraction  in  the  minute  vessels  of  the  skin  giving  place  to 
dilatation,  so  that  the  whole  surface,  including  the  extremities, 
becomes  hot  and  burning,  but  still  dry  and  parched.  The  burn- 
ing is  especially  noticeable  in  the  more  vascular  parts,  like  the 
roots  of  the  horns  and  ears,  the  muzzle  or  snout,  the  mouth,  the 
hoofs,  the  bare  parts  of  the  paws  in  carnivora,  and  the  mammae 
(udder)  in  suckling  animals.  The  mucous  membranes  lining  the 
nose  and  mouth  become  hot  and  red,  the  breathing  freer,  but  not 
less  rapid,  the  pulse  softer  but  accelerated,  appetite  (and  rumina- 
tion) greatly  impaired  or  lost,  thirst  great,  costiveness  increased. 


Fever.  6i 

urine  diminished  and  of  a  higher  color,  the  flow  of  milk  greatly 
impaired  or  entirely  arrested,  and  the  dullness  and  prostration 
greatly  increased. 

The  hot  stage  lasts  longer  than  the  cold  one,  usually  persisting 
until  death  or  convalescence.  It  may  alternate  with  chills 
throughout  the  whole  course  of  the  illness,  and  in  the  fever  of  in- 
flammation the  interruption  of  the  hot  stage  by  a  chill  usually  im- 
plies either  a  considerable  extension  of  the  inflammation  or  the 
occurence  of  suppuration. 

Defervescence.  The  decline  of  the  fever  may  take  place  by  a 
sudden  reduction  of  the  body  temperature  to  the  natural  standard, 
or  near  it,  and  a  sudden  and  general  improvement  in  the  symp- 
toms (cri.sis),  or  by  a  slow  improvement  from  day  to  day  through 
a  more  or  less  tedious  convalescence  (lysis). 

Fever  Temperatiwe.  A  temporary  rise  of  one  or  two  degrees  is 
unimportant,  but  a  permanent  rise  indicates  fever.  A  rise  of  ten 
or  twelve  degrees  is  usually  fatal.  A  sudden  fall  to  or  below  the 
natural,  unless  with  general  improvement  in  the  symptoms  indi- 
cates siiiking.  A  similar  fall,  with  a  free  secretion  (perspiration, 
urination,  relaxed  bowels)  and  general  improvement  in  symp- 
toms, betokens  recovery.  For  normal  and  febrile  temperature  see 
Semeiology. 

Retention  of  tvater  in  the  fevered  system  is  as  significant  as  the 
elevated  temperature.  The  patient  drinks  greedily  but  all  the  se- 
cretions are  arrested  or  diminished,  and  liquids  go  on  accumulat- 
ing in  the  system.  The  sudden  bursting  forth  of  secretions 
(especially  sweating)  implies  that  the  fever  has,  at  least  tempo- 
rarily, given  way. 

The  production  of  waste  matters  in  the  system  is  necessarily  pro- 
portionate to  the  amount  of  tissue  destroyed.  This  appears  in 
the  blood  mainly  as  urea,  the  organic  acid  of  urine  (hippuric  in 
herbivora,  uric  in  carnivora),  together  with  phosphates,  sulphates, 
and  chlorides.  These  thrown  off  by  the  urine  give  it  its  high 
density.  If  not  thus  thrown  off  they  remain  as  poisons  in  the 
circulation  and  bring  about  that  prostrate,  sunken,  debilitated 
condition  which  characterizes  the  advanced  stages  of  all  severe 
and  continued  fevers — the  typhoid  condition.  This  is  not  to  be  con- 
founded with  the  specific  typhoid  fever,  in  which  a  special  fever 
germ  expends  itself,  mainly  on  the  bowels,  and  that  runs  through 


62  Veterinary  Medicine. 

a  regular  course.  The  typhoid  cojidition  is  that  state  in  which  an 
animal  system,  already  greatly  weakened  by  a  severe  disease,  and 
perhaps  further  prostrated  by  a  specific  disease-poison,  is  subject- 
ed to  a  species  of  poisoning  by  the  retained  chemical  products  of 
the  waste  of  the  tissues. 

Types  of  Fever.  These  are  as  characteristic  as  the  types  of  in- 
flammation, and  of  the  same  kind.  The  strong  type  of  fever 
which  attends  on  an  acute  inflammation  in  an  otherwise  healthy 
vigorous  system,  is  spoken  of  as  a  high  or  iyiflatiimatory  fever. 
The  weak  type  which  occurs  in  a  broken  down  or  debilitated  sys- 
tem, or  in  connection  with  the  action  of  a  specific  disease  germ, 
or  with  the  saturation  of  the  system  by  waste  chemical  products 
is  known  as  low,  typhoid  (better  typhous^,  or  adynamic  fever. 
That  form  which  persists  in  the  utterly  debilitated  .system,  where 
the  power  of  assimulation  is  practically  lo.st,  is  known  as  hectic. 

TREATMENT    OF    INFLAMMATION    AND    FEVER. 

Treatment  will  be  guided  very  largely  by  the  type  of  the  at- 
tendant fever.  If  that  is  of  a  high  type,  with  a  hard,  full,  rapid 
pulse,  bright  red  mucous  membranes,  a  clear  eye,  and  well  sus- 
tained strength  in  a  strong,  vigorous  animal,  what  is  known  as 
antiphlogistic  (depleting,  depressing)  treatment  is  admissible  at 
the  outset.  But  in  many  cases  with  a  low  type  of  fever,  a  weak, 
rapid  pulse,  pallid,  yellow,  or  livid  mucous  membranes,  a  coated 
tongue,  a  dull  or  sunken  eye,  much  depression  and  prostration, 
swaying  on  the  limbs  in  walking,  pendant  head,  ears,  eyelids  and 
lips,  and  varying  and  irregular  temperature  of  the  limbs,  etc. , 
such  measures  are  forbidden  from  tl^e  first,  and  tonics  and  stimu- 
lants are  demanded  from  the  outset.  Between  the  two  extremes 
there  are  many  grades,  which  demand  a  judiciously  adjusted  in- 
termediate treatment.  The  general  principles  only  of  each  char- 
acteristic form  of  treatment  can  be  here  formulated,  it  being  un- 
derstood that  no  two  cases  can  be  most  advantageously  treated  in 
precisely  the  same  way,  but  that  according  to  its  special  grade 
each  case  will  demand  its  own  specific  management  applied  ac- 
cording to  the  skill  of  the  physician. 

Regimen.  An  antiphlogistic  diet  will  consist  in  a  moderate  or 
very  sparing  amount  of  non-stimulating  food  of   easy  digestion 


Infla^nmation,   Fever,    Treatment.  63 

(wheat  bran  or  oil  meal  in  warm,  sloppy  mash,  carrots,  turnips, 
beets,  potatoes,  apples,  pumpkins  ;  fresh,  tender,  green  grass  or 
in  winter  a  little  scalded  hay,  may  be  taken  as  examples).  Riim- 
inants  should  have  no  food  necessitating  chewing  of  the  cud  ; 
thus  the  roots,  etc.,  should  be  pulped  or  boiled,  and  hay  and 
even  grass  must  be  interdicted  until  rumination  is  re-established. 
When  food  is  absolutely  refused  for  days  in  succession  well-boiled 
gruels  of  oat-meal,  barley-meal,  linseed-meal,  bran,  etc.,  may  be 
given  from  a  bottle  or  by  injection.  Dogs  and  cats  should  have 
only  vegetable  mush  (unbolted  flour,  barley,  or  oat-meal)  with 
just  enough  beef-juice  to  tempt  the  animal  to  eat  a  little.  Milk 
with  an  admixture  of  oxide  of  magnesia,  or  even  lime-water  is 
often  at  once  palatable  and  cooling.  Drink  should  be  pure  water, 
cool,  if  kept  constantly  fresh  before  the  animal,  but  warmed  to 
something  less  than  tepid  if  supplied  only  at  long  intervals,  so 
that  the  thirsty  patient  is  not  tempted  to  drink  to  excess  and  chill 
himself.  Rest  in  a  clean,  well-aired  building,  free  from  draughts 
of  cold  air  and  with  a  southern  exposure,  is  desirable,  especiall}' 
in  winter.  The  best  temperature  is  usually  sixty  degrees  to  sev- 
enty degrees,  especially  in  inflammations  in  the  chest,  and  ex- 
tremes of  temperature  are  to  be  avoided.  Clothmg  will  depend 
on  the  weather.  In  warm  weather  it  may  be  often  discarded, 
while  in  winter  it  should  always  be  sufficient  to  obviate  the  access 
of  chill  and  consequent  aggravation  of  the  disease.  Whenever 
the  atmosphere  can  be  kept  warm  only  at  the  expense  of  impurity 
it  is  better  to  secure  the  comfort  of  the  patient  by  the  requisite 
clothing  than  to  subject  him  to  impure  air.  As  the  extremities 
are  the  first  to  suffer  from  cold,  loose  flannel  bandages  to  the 
limbs  are  often  imperative. 

Remedies.  General  bleeding,  a  great  resort  of  our  fore-fathers, 
has  been  long  all  but  discarded  from  modern  practice.  To-day  it 
is  rarely  resorted  to,  except  to  save  from  an  urgent  and  extreme 
danger,  as  in  the  plethoric  cow  merging  into  parturient  apoplexy, 
or  the  fat  and  overdriven  horse,  gasping  for  breath  and  life,  in 
general  acute  congestion  of  the  lungs.  There  are  other  cases  of 
extensive  acute  and  dangerous  congestions,  especially  in  a  strong, 
vigorous,  and  plethoric  patient,  in  which  general  bleeding  in  ben- 
eficial in  warding  off  threatened  death ;  but  sound,  discriminating 
judgment  is  necessary  to  its  safe  employment.     When  resorted  to 


64  Veterinary  Medicine. 

at  all,  the  blood  should  be  drawn  from  a  large  orifice,  in  a  full 
stream,  to  secure  the  desired  depressant  effect  with  the  smallest 
loss  of  blood,  and  the  patient  should  be  kept  especially  quiet  and 
apart  from  all  excitement  which  would  tend  to  counteract  the 
sedative  action. 

Local  bleeding  is  more  extensivelj'  applicable  than  general,  as 
it  usually  effects  the  same  purpose  without  the  permanently  weak- 
ening effect.  It  acts  in  two  ways,  first,  by  emptying  and  con- 
tracting the  vessels  in  the  skin  over  the  inflamed  organ,  it  solicits 
a  sympathetic  contraction  of  the  capillary  vessels  in  that  organ 
itself,  and  thus  inaugurates  a  progress  toward  recovery  ;  and 
sscond,  by  so  much  as  it  draws  blood  to  the  surface  it  diminishes 
the  blood-pressure  on  the  deeper  inflamed  organ,  and  affords  a 
better  opportunity  for  the  restoration  of  the  healthy  circulation 
and  function.  Local  bleeding  may  be  practiced  by  simple  scarifi- 
cation or  leeches,  or  better,  by  cupping  with  or  without  scarifica- 
tion. To  apply  leeches,  the  skin  must  first  be  shaved.  To  cup, 
it  must  at  least  be  greased.  As  a  cup,  an  ordinary  large  drink- 
ing-glass  may  be  used,  the  air  contained  in  it  being  driven  out  by 
a  lighted  taper,  and  then  the  taper  being  withdrawn,  the  mouth 
of  the  cup  is  instantly  and  accurately  applied  on  the  skin  and 
held  there,  until,  as  it  cools,  it  draws  up  the  skin  within  it  and 
clings  like  a  sucker.  A  number  of  these  may  be  applied  accord- 
ing to  the  extent  of  the  inflammation,  and,  if  desired,  they  may 
be  removed,  the  part  scarified,  and  the  cup  reapplied.  The  cup- 
ping usually  effects  more  than  a  mere  local  attraction  of  blood  ; 
it  very  commonly  causes  a  free  circulation  in  the  whole  skin,  a 
generally  diffused  warmth,  and  even  perspiration.  Thus  we  may 
secure  the  derivation  of  blood  from  the  inflamed  part,  the  cooling 
of  a  large  mass  of  blood  in  the  extensive  cutaneous  circulation, 
the  cooling  of  the  entire  system  by  the  return  of  this  blood  inter- 
nally, the  elimination  of  injurious  waste  matters  through  the 
skin,  the  lowering  of  the  febrile  heat  and  tension,  and  a  better 
functional  activity  of  all  the  organs  of  the  body. 

Similar  good  results  are  obtained  from  all  remedies  that  induce 
surface  warmth  and  vascularity  and  a  free  secretion  from  the  skin. 

Warm  baths,  for  animals  to  which  they  can  be  applied,  abstract 
blood  temporarily  from  the  inflamed  internal  organs,  diminish  the 
blood-pressure,  and  really  cool  the  system,  beside  securing  elimi- 


Inflamuiation,  Fever,    Treatment.  65 

nation  from  the  skin  and  other  secreting  surfaces.  They  may  be 
commenced  warm  (80°  F.)  and  gradually  cooled  down  to  65°  F. 
after  the  skin  has  become  freely  active.  In  the  larger  quadru- 
peds, in  which  the  warm  bath  is  too  often  practically  impossible, 
the  same  revulsion  of  blood  and  warmth  to  the  skin  may  be  se- 
cured by  rags  ivrung  out  of  hot  (^almost  scalding')  water,  wrapped 
tightly  round  the  body,  covered  with  two  or  more  dry  blankets, 
and  kept  tightly  applied  against  the  surface  by  elastic  circingles. 
The  legs  may  be  rubbed  with  straw  wisps  till  warm,  and  then 
loosely  bandaged,  or  applications  of  red  pepper,  ammonia,  or 
mustard,  may  be  made  prior  to  bandaging.  In  place  of  hot  water 
rugs,  bags  loosely  filled  with  bran,  chaff,  or  other  light  agent, 
heated  to  1 10°  F. ,  may  be  applied  round  the  body,  or,  where  it  is 
available,  a  Turkish  or  steam  bath  may  be  resorted  to.  These 
hot  cutaneous  applications,  to  produce  glow  and  perspiration,  are 
especially  valuable  in  the  chill  that  heralds  a  violent  inflamma- 
tion, and  if  that  can  be  suddenly  checked  by  this  means  the  in- 
flammation will  often  be  warded  off,  or  at  least  rendered  slight 
and  easily  controllable.  After  perspiring  for  half  an  hour  the 
patient  may  be  gradually  uncovered,  rubbed  dry,  and  covered 
with  a  dry,  warm  blanket.  If  the  skin  is  still  glowing,  a  slight 
sponging  with  cool  or  cold  water  may  beneficially  precede  the 
rubbing  and  drying. 

Cold  Baths.  In  cases  of  very  high  fever  a  full  cold  bath 
(68°  F.)  may  be  employed  for  fifteen  minutes,  and  repeated  as 
often  as  the  temperature  rises.  In  many  cases  of  parturition 
fever  in  cows  great  benefit  accrues  from  sponging  the  body  with 
cold  water  and  allowing  it  to  evaporate  from  the  burning  skin. 
In  the  extreme  fever  of  heat  apoplexy  (sunstroke),  with  a  tem- 
perature of  110°  F.  and  upward,  a  strong  current  of  cold  water 
from  a  hose  directed  on  the  head  and  body  often  gives  the  best 
results.  In  ordinary  fevers  in  large  animals  the  cold  pack  will 
often  serve  a  good  purpose.  Wring  a  blanket  out  of  water  (cold 
or  tepid,  according  to  the  height  of  the  fever  and  the  strength 
and  power  of  reaction  of  the  patient),  wrap  it  round  the  body, 
cover  it  with  several  dry  blankets  so  that  no  part  is  exposed,  and 
keep  the  whole  in  close  contact  with  the  skin  by  elastic  circingles. 
In  fifteen  minutes  the  skin  should  be  glowing  and  perspiring,  and 
in  half  an  hour  the  wrappings  should  be  removed,  a  little  at  a 
5 


66  Veterinary  Medicine. 

time,  the  parts  rubbed  dry  and  covered  with  a  dry  woolen  blanket. 
It  may  be  repeated  as  often  as  the  fever  rises. 

Diaphoretics.  Besides  these  remedial  methods  of  inducing  a 
revulsion  and  glow  in  the  skin  with  perspiration,  medicinal  dia- 
phoretics may  be  resorted  to.  Among  these  may  be  included 
copious  drinks  and  injections  of  warm  water,  acetate  of  ammotiicr, 
ayitimony,  ipecacuan,  or  pilocarpi?i,  or  one  of  the  sedatives,  aconite 
veratum,  or  opium,  etc.  Many  a  threatened  acute  inflammation 
has  been  to  a  great  extent  cut  short  and  nipped  in  the  bud— the 
stage  of  chill — by  warm  clothing,  active  hand-rubbing,  and  such 
an  apparently  unscientific  nauseant  as  tobacco. 

When  the  preliminary  stage  has  passed  and  the  hot  stage  of  the 
fever  has  set  in,  cooling  and  eliminating  agents  are  especially 
called  for. 

Laxatives.  In  many  cases,  and  especially  in  those  with  marked 
constipation  or  bowels  loaded  with  indigestible  materials,  a  laxa- 
tive is  beneficial.  For  the  horse,  aloes,  or,  often  better,  sulphate 
of  soda,  and  for  cattle  or  sheep,  the  latter,  or  Epsom  salts,  will  at 
once  remove  an  irritant,  cool  the  general  system,  draw  off  much 
blood  and  nervous  energy  to  the  bowels,  and  secure  a  considerable 
depletion  and  elimination  from  the  intestines.  For  swine,  dogs, 
and  cats  castor-oil  or  salts  may  be  used,  and  for  fowls  castor-oil. 
If  the  mucous  membranes  are  yellow,  the  tongue  furred,  and 
faeces  scanty,  hard,  and  foetid,  a  dose  of  calomel  (horse  or  ox, 
one  drachm  ;  sheep  or  pig,  one  scruple ;  dog,  three  grains  ; 
chicken,  one-half  grain)  with  tartar  emetic  (horse  or  ox,  two 
drachms ;  sheep,  twenty  grains  ;  swine,  one-half  grain  ;  dog, 
one-fourth  grain ;  chicken,  one-eighth  grain)  may  be  given  and 
followed  in  ten  hours  by  one  of  the  laxatives  named  above. 

Diuretics.  In  the  absence  of  any  manifest  disorder  of  the  di- 
gestive organs,  the  laxative  may  be  omitted  and  refrigerant  diur- 
etics resorted  to.  Acetate  of  ammonia  or  potassa,  nitre,  tartrate 
of  potassa,  carbonates  of  potassa  or  soda,  may  be  used  along  with 
sedatives. 

In  cases  of  infectious  disease  with  poisoning  by  ptomaines  and 
toxins  the  elimination  of  these  by  the  bowels  and  kidneys  is  of  the 
greatest  importance. 

Sedatives.  Of  the  sedatives,  aconite,  bromide  of  potasium,  ver- 
atrum,  hyoscyamus,  or  chloral  hydrate  may  be  used  according  to 
the  special  indications. 


Inflammation,   Fever,    Treatment.  67 

Alkalies.  Resolvoits.  When  the  organ  inflamed  is  a  serous 
membrane  in  which  dangerous  adhesions  or  other  functional  dis- 
orders are  likely  to  occur  from  newly  formed  false  membranes, 
their  formation  should  be  counteracted  as  far  as  possible  by  the 
free  use  of  alkalies  (carbonates  of  soda,  potash,  or  ammonia, 
nitre,  iodide  of  potassium,  muriate  of  ammonia,  etc.),  and  in  the 
same  conditions  excessive  effusion  should  be  controlled  by  free 
action  on  the  kidneys. 

Antipyretics.  To  reduce  the  febrile  temperature  and  especi- 
ally, when  caused  by  the  ptomaines  and  toxins  of  bacterial  infec- 
tion, agents  like  acetanilid,  antipyrin,  exalgin,  analgene,  benzan- 
ilid,  salicylate  of  soda,  and  quinine  have  been  largely  employed 
and  will  usually  lower  the  temperature  several  degrees  in  a  few 
hours.  They  nearly  all  depress  the  vital  forces,  or  hinder  repar- 
atory  processes,  so  that  their  use  is  to  be  carefully  guarded. 
Quinine  which  is  less  depressing  than  the  others  hinders  migration 
of  the  leucocytes  and  thus  stands  in  the  way  of  successful  phago- 
cytosis. With  a  dangerously  high  temperature  they  may  be  tem- 
porarily admissible,  but  they  should  be  suspended  as  soon  as  pos- 
sible. In  all  ordinary  cases  they  are  probably  better  avoided.  A 
judicious  use  of  the  cold  or  tepid  bath,  or  of  wet  compresses  is  in- 
comparably safer  and  more  generally  applicable. 

Stimulants.  When  the  disease  results  in  great  prostration  or 
when  symptoms  of  septic  or  ptomaine  poisoning  set  in  stimulants 
are  often  required  to  sustain  the  flagging  heart  and  circulation. 
These  may  be  alcoholic,  ammoniacal,  etherial,  camphor,  digitalis, 
etc. 

Tonic  Refrigerants.  Later,  when  both  inflammation  and  fever 
have  been  somewhat  reduced,  temperature,  breathing,  and  pulse 
rendered  more  moderate,  eye  clearer,  and  even  appetite  perhaps 
slightly  improved,  the  sedatives  may  give  place  to  refrigerating 
tonics,  such  as  mineral  acids  (nitric,  muriatic,  sulphuric,  or  phos- 
phoric), in  combination  with  bitters  (quassia,  cascarilla,  calumba, 
gentian,  salicin),  without  as  yet  the  suspension  of  refrigerant  di- 
uretics. Thus  for  the  horse  the  following :  Recipe  :  Pharmaceu- 
tical nitric  acid,  two  drams  ;  infusion  of  gentian,  ten  ounces  ; 
nitrate  of  potassa,  two  ounces.  Dissolve.  Give  one  ounce  every 
six  hours. 

Li  Cotivalesce?ice.     When  convalescence  has  fairly  set  in,   the 


68  Veterhiary  Medicine. 

fever  has  subsided,  and  there  reinauis  merely  some  debiHty  with 
a  remnant  of  the  inflammatory  exudation  to  be  removed  or 
organized  into  tissue,  or  when  an  abscess  has  developed  and  burst, 
the  tonics  must  be  even  more  freely  given,  the  mineral  acids  may 
even  give  place  to  preparations  of  iron  or  cod-liver  oil,  and  the 
diet  must  be  made  increasingly  liberal.  But  throughout  the 
whole  progress  of  the  disease  the  bowels  should  be  carefully 
watched.  Costiveness  may  quickly  undo  all  that  has  been  gained, 
hence  any  indication  of  this  should  be  met  by  laxative  food 
(boiled  flaxseed,  etc.),  or,  this  failing,  by  injections  or  laxatives. 
Similarly,  if  a  freer  action  of  the  kidneys  seems  to  be  necessary 
for  elimination  of  waste  matters  or  to  reduce  fever,  diuretics 
should  be  continuously  kept  up. 

Treatment  of  Adynamic  Infi^ammation  and  Fever.     In 
treating  low  asthenic  or  ady^iamic  itiflamviation  all  depression  and 
depletion  is  to  be  carefully  avoided.     Even  laxatives  must  be  em- 
ployed with  extreme  caution.     If  absolutely  necessary  it  is  best  to 
give  them  in  small  (half)  doses  and  supplement  their  action  by 
liberal  injections  of  hot  water.     Elimination  of  waste  matter  from 
the  blood  and  system  is  still  to  be  sought,  but  it  must  be  by  stim- 
jilating  diuretics  (sweet  spirits  of  nitre,  carbonate,  acetate,  or  mu- 
riate of  ammonia,  digitalis),  and  direct  stinndants  and  tonics  must 
be  given  from   the  first   (ammonia,    wine,   strong  ale,    whisky, 
brandy,  ether,  gentian,  calumba,   nux  vomica).     For  thehor.se 
the  following  may  serve  as  an  example  :  Recipe  :    Sweet  spirits 
of  nitre,  four  ounces  ;  sulphuric  ether,  two  ounces  ;  tincture  of 
gentian,    ten   ounces ;  digitalis,    one    dram.     Mix.     Dose,    two 
ounces  in  a  pint  of  cool  water  four  times  a  day.     When  there  is 
great  debility  and  prostration  ammoniacal  and  alcoholic  stimulants 
must  be  given  freely,  while  if  the  fever  heat  rises  very  unduly 
the  cooling  diuretics  (citrate,  tartrate,   or  acetate  of  potassa,  or 
nitre,  etc.),  and  even  sedatives  (bromide  of  potassium,  hydro- 
bromic  acid,  chloral  hydrate,  salacin,  salicylate  of  soda),  must  be 
resorted  to.     If  there  is  any  indication  of  a  special  depressing  poi- 
son in  the  system,  or  of  the  absorption  of  septic  or  other  noxious 
matter  from  a  wound,  antiseptics  (hydrochloric  acid,  or  salicylic 
acid,  sulphite  of  soda,  quinia,  or  chlorate  of  potassa)  may  be  ad- 
vantageously added  to  the  prescription. 

In  these  cases  of  asthenic  inflammation,  as  in  the  advanced  and 


Inflamuiation,   Fever,    Treatment.  69 

debilitated  stages  of  sthenic  inflammation,  the  diet  should  be  as 
good  as  the  patient  can  digest.  Boiled  oats,  barley,  or  flaxseed, 
rich,  well-boiled  gruels,  and  beef-tea  (even  for  herbivora,)  may 
frequently  be  resorted  to  with  advantage. 

Local  Treatment  of  Inflammatio7i.  In  all  forms  of  superficial 
inflammation  the  local  treatment  occupies  an  important  place. 
The  persistent  application  of  <r<?/^  (coldwaterin  a  stream,  ice-bags, 
freezing  mixtures)  will  sometimes  overcome  the  tendency  to  in- 
flammation or  arrest  it.  This  is  especially  sought  when  a  violent 
inflammation  (as  in  a  wounded  joint)  threatens  to  destroy  an  im- 
portant organ.  If  adopted,  it  must  be  persisted  in,  as  if  it  is  sus- 
pended too  soon  the  reaction  is  likely  to  make  matters  worse  than 
ever.  Cold  astringent  applicatio7is  have  a  similar  tendency. 
Sugar-of-lead,  one-half  ounce  ;  laudanum,  one  ounce  ;  water,  one 
quart,  may  be  kept  applied  by  means  of  a  linen  bandage.  The 
water  may  often  be  advantageously  replaced  by  extract  of  witch- 
hazel.  If  the  inflamed  part  is  superficial  the  lotion  may  be  made 
antiseptic  (carbolic  acid,  one  dram  ;  or  sulphurous  acid  solution, 
five  ounces  ;  water,  one  quart).  Hot  applications,  fomentatio7is, 
poultices  are  nearly  always  appropriate  but  they  should  be  made 
antiseptic  to  prevent  bacterial  development.  When  adopted  they 
should  like  cold  ones  be  kept  up  as  continuously  as  possible. 
These  soothe  alike  the  superficial  and  deeper  parts,  the  latter 
through  sympathy,  producing  first  a  relaxation  of  vessels  and  tis- 
sues, and  later  a  contraction  of  the  former  attended  by  pallor  of 
the  surface.  They  greatly  favor  suppuration  when  that  is  already 
inevitable,  though  in  other  cases  they  may  obviate  it  by  checking 
at  an  early  stage  the  acute  inflammatory  process  on  which  it  de- 
pends. Any  bland  agent  that  will  retain  heat  and  moisture 
will  make  an  excellent  poultice,  though  fllaxseed-meal  is  the  type 
of  a  soothing  demulcent  application.  Very  slight  inflammation 
may  be  successfully  treated  at  the  outset  with  a  stimulating  em- 
brocation (alcohol  or  camphorated  spirit),  yet  in  the  more  violent 
type  of  acute  inflammation  all  local  excitants  tend  to  aggravate 
the  disease.  In  these  violent  forms  the  activity  of  the  disease 
should  be  first  abated  by  local  soothing  and  general  sedative  meas- 
ures, and  then  the  part  over  the  inflamed  organ  may  be  safely 
treated  with  a  stimulating  liniment  or  even  a  blister.  In  such 
cases  the  liniment  first  acts  as  a  derivative  of  blood  and  nervous 


yo  Veterinary  Medicine. 

energy  from  the  inflamed  part,  and  later  and  still  more  beneficially 
by  securing  in  it  a  sympathetic  healing  process,  like  that  set  up 
in  the  skin.  It  is  further  probable  that  the  absorbed  albuminoids, 
which  have  been  modified  in  the  congested  part  often  exercis2a  de- 
cided effect  on  the  inflamed  tissue.  In  raw  .sores  where  inflam- 
mation has  been  .set  up  the  granulations  may  become  dropsical  or 
excessive,  bulging  beyond  the  adjacent  skin  Q.spro2cd  Jies/i.  This 
should  be  repressed  by  touching  it  gently  with  some  mild  caustic 
(lunar  caustic),' so  as  to  produce  a  thin,  white  film,  and  the  re- 
mote cause  of  the  inflammation  (often  a  local  irritant)  should  be 
sought  and  removed.  In  some  unhealthy  sores  tending  to  exces- 
.sive  granulation,  the  compound  tincture  of  myrrh  and  aloes  may 
be  applied  daily  with  great  benefit.  When  the  granulations  be- 
come excessive  they  may  be  scraped  down  to  the  level  of  the 
.skin  and  then  treated  with  an  antiseptic  (iodoform,  boric  acid, 
acetanilid,  aristol. 

Blistering.  In  subacute  and  chronic  inflammations  and  in 
those  acute  forms  in  which  the  violence  of  the  inflammatory 
action  has  been  already  subdued  by  soothing  measures,  blisters 
and  other  counter-irritants  may  be  employed  to  counteract  the 
remaining  inflammatory  action.  These  act  primarily  by  drawing 
off  blood  and  nervous  energy  from  the  inflamed  organ  to  the 
skin,  and  secondarily,  by  establishing  a  sympathetic  healing  pro- 
cess in  the  diseased  part,  simultaneously  with  the  work  of  recov- 
ery in  the  skin,  when  the  blister  has  spent  its  action.  But  if 
applied  above  a  part  which  is  still  violently  inflamed,  there  is  apt 
to  be  serious  aggravation,  through  this  same  sympathy 
with  the  part  .suffering  under  the  rising  of  the  blister.  In  this 
way  great  and  irreparable  injury  is  often  done  through  the  lauda- 
tions of  particular  blisters  for  the  cure  of  given  diseases,  without 
any  reference  to  the  stage  or  grade  of  such  di.sea.se.  The  value 
of  a  blister  depends  far  more  on  the  time  of  its  application  than 
on  the  ingredients  of  which  it  may  be  composed. 

Firing.  This  acts  in  nearly  the  same  manner  as  a  blister,  and 
demands  similar  caution  in  its  application.  It  is  especially  avail- 
able in  subacute  and  chronic  diseases  of  the  joints,  bones,  and 
tendons,  and  may  be  made  more  or  le.ss  severe  according  to  the 
nature  and  obstinacy  of  the  disease.  It  is  applied  in  points  or  in 
lines  at  intervals  of  one-half  to  one   inch,  and   penetrating  one- 


Inji animation,   Fever,    Treatment.  71 

third,  one-half,  or  entirely  through  the  skin.  The  hotter  the  iron 
the  less  the  pain,  but  the  greater* the  danger  of  destruction  of  the 
intervening  skin  by  the  excess  of  radiating  heat.  Hence  the 
contact  of  the  heated  iron  with  any  one  part  must  be  judiciously 
graduated  to  the  heat  of  the  iron  and  the  delicacy  of  the  skin, 
and  should  not  exceed  the  fraction  of  a  second. 

Massage,  Rubbing.  In  chronic  inflammation  and  even  in  some 
acute  forms,  with  considerable  exudation,  rubbing  or  massage  is 
of  great  value.  It  hastens  the  progress  of  the  blood  through  the 
veins,  tends  to  restore  the  normal  circulation  in  the  stagnant  or 
partially  obstructed  capillaries,  moves  on  the  exuded  liquids  in 
the  lymphatic  plexus,  rend2ring  the  absorption  more  active,  and 
at  once  prevents  the  process  of  disintegration  of  the  tissues  and 
obviates,  the  necessity  for  their  solution  and  removal.  This  may 
be  largely  accomplished  by  the  use  of  the  brush  or  rubber,  or  by 
careful  manipulation  especially  in  the  direction  of  the  veins.  If 
the  inflammation  is  near  the  surface  the  use  of  antiseptic  and 
deobstruent  agents  will  heighten  the  good  effect.  Iodoform, 
iodide  of  potassium,  boric  acid  may  serve  as  examples. 

Suppuration.  Abscess.  The  great  variety  of  the  causes  and 
forms  of  suppuration  would  forbid  any  extended  notice  of  its 
treatment  in  this  place.  It  seems  preferable  to  refer  the  reader 
to  the  subject  of  p3"semid  and  the  various  surgical  and  medical 
diseases  in  which  suppuration  takes  place. 


DISEASES  OF  THE  RESPIRATORY   ORGANS. 

Importance  of  diseases  of  the  respiratory  organs — in  horses  and  dogs. 
Proclivity  through  over-exertion,  through  extent  and  delicacy  of  the  mu- 
cosa, through  changes  of  temperature,  through  weather,  through  air  pollu- 
tion, through  kind  of  diet,  through  change  of  latitude,  through  nervous 
sympathy,  through  debilitation  of  the  lung  tissue,  through  suppression  of 
perspiration,  through  a  high  dew  point,  through  bacteria  and  other  germs, 
through  youth  and  change  of  habits. 

These  are  among  the  most  freqvient  and  grave  of  all  affections 
of  the  domestic  animals.  They  are  especially  important  however 
in  the  case  of  animals  that  depend  on  the  soundness  of  their  wind. 
In  horses  and  dogs  accordingly  anj^  permanent  injury  to  the  or- 
gans of  respiration  will  seriously  impair  the  value,  not  only  be- 
cause of  the  diminished  usefulness  of  the  affected  animal,  but  also 
because  of  the  probable  deterioration  of  their  progeny.  The 
rapid  paces  demanded  of  these  animals  and  the  strain  to  which 
the  respiratory  organs  are  subject  are  potent  causes  of  respiratory 
disorder.  In  all  animals,  however,  the  extent  of  the  respiratory 
surface  and  its  extreme  delicacy  and  tenuity  especially  predis- 
pose it  to  disease.  Hales  estimates  that  the  mucous  membrane 
covering  all  the  air  sacs  and  air  cells  is,  in  the  calf,  no  less 
than  250  square  feet.  As  the  chest  of  the  horse  is  at  least 
double  that  of  the  calf,  and  as  it  contains  much  less  connective 
tissue,  and  is  made  up  of  minute  air  cells  from  j^^  —  -^^q  inch  in 
diameter  and  separated  from  each  other  by  walls  so  attenuated 
that  the  contained  capillary  blood-vessels  are  equally  exposed  to 
the  air  on  both  sides,  in  two  adjacent  air  cells,  the  estimate  for 
the  average  horse  must  be  considerably  above  500  square  feet. 
This  membrane,  incomparably  the  most  delicate  and  susceptible 
in  the  animal  economy,  is  constantly  in  contact  with  the  air  in  all 
its  variable  conditions,  and  is  necessarily  affected  by  these  varia- 
tions. 

The  severe  changes  of  temperature  are  not  without  their   influ- 
ence on  this  sensitive  membrane.     If  these  changes  are   sudden, 
as  for  example  in  our  northern  states  where  the  temperature  will 
var}'  from  50°  to  70°  Fall.,  in  a  single  day,  the  danger   of  injury 
72 


Diseases  of  the  Respiratory  Organs.  73 

becomes  imminent,  and  the  lungs  require  to  be  strong  indeed  to 
resist  their  eiEFects.  Sudden  transition  from  the  hot  close  atmos- 
phere of  the  barn  or  stable  to  the  chilling  winds  of  winter  is 
equalh'  hurtful.  But  it  is  not  alone  the  transition  from  warmth 
to  cold  that  is  injurious.  The  general  relaxation  attendant  on 
the  sudden  change  from  a  cold  bracing  atmosphere  to  one  undulj' 
hot  is  even  more  injurious.  How  frequently  do  human  beings 
suffer  from  colds  as  the  result  of  a  close  sultry  period  at  once  su- 
pervening on  a  clear  cold  one  ?  How  extensively  do  chest  dis- 
eases prevail  among  horses  brought  from  the  clear  pure  atmos- 
phere of  the  field,  and  shut  up  in  close,  hot  stables  ?  Here,  no 
doubt,  there  is  superadded  the  impurity  of  the  too  often  infected 
air,  the  change  of  diet,  of  exercise  and  of  general  care  3'et  we 
find  that  affections  of  the  air  passages  are  to  a  great  extent  in 
ratio  with  the  heat  of  the  building.  Hence  their  constant  pres- 
ence in  dealer's  stables  where  it  is  thought  desirable  to  keep  the 
horses  warm  to  hasten  the  improvement  in  the  coat. 

The  suddenness  of  the  transition  is  usually  a  principal  cause  of 
injury.  Where  the  climate  changes  slowly  the  animal  economy 
becomes  habituated  to  it  and  resists  successfully  the  injurious  in- 
fluences. Thus  when  spring  merges  gradually  into  summer  and 
autumn  into  winter,  diseases  of  this  kind  are  far  less  frequent. 
But  on  the  other  hand  a  sudden  and  extreme  variation  of  tem- 
perature, whether  in  the  ordinary  course  of  the  season  or  from  a 
wide  change  of  latitude,  is  notoriously  attended  with  diseases  of 
the  air  passages.  Ayrshire,  shorthorn  and  Jersey  cattle,  when 
first  imported  into  the  Northern  States  of  America,  contract  colds, 
consumption  and  other  chest  diseases  to  a  far  greater  extent  than 
the  native  races,  though  their  progeny  or  even  they  themselves 
after  acclimatization,  exhibit  powers  of  resistance  nearly  equal  to 
the  native  stock.  Sheep  that  have  been  shorn  in  midwinter  or 
early  spring  often  repay  the  inhumanity  of  their  owners  by  dying 
of  inflamed  lungs.  Southdown  and  Leicester  sheep,  sent  from 
England  to  the  north  of  Scotland,  demand  at  first  the  greatest 
care  to  protect  them  against  the  increased  rigor  of  the  climate. 
The  army  veterinary  statistics  of  France  show  that  horses  trans- 
ported from  the  southern  parts  of  the  country  to  the  more  northern 
stations,  suffer  largely  from  pulmonary  affections.  But  if  the 
change  is  effected  slowly  the  requisite  powers  of  resistance  are 


74  Veterinary  Medicine. 

acquired  and  the  novel  conditions  of  life  cease  to  be  injurious. 
That  this  varied  power  of  resistance  is  not  confined  to  the  higher 
animals  would  appear  from  the  experiments  of  W.  Edwards  on 
cold  blooded  animals.  He  subjected  them  in  winter  and  in  sum- 
mer respectively  to  a  very  low  temperature  and  found  that 
whereas  in  summer  their  temperature  declined  3°  to  6°  Cent.,  in 
winter  they  had  a  greater  resistance  and  barely  declined  y\ths  of 
a  degree. 

The  action  of  cold  on  the  surface  of  the  body  often  leads  to 
morbid  states  of  the  air  passages  as  the  result  of  nervous  sympa- 
thy. A  beast  is  subjected  to  a  keen  cold  wind,  is  attacked  with 
shiv^ering,  and  inflammation  of  the  chest  supervenes.  The  result 
is  rendered  more  certain  if  the  wind  is  associated  with  rain  and 
if  the  animal  has  been  previously  in  a  state  of  perspiration.  A 
heavy  coat  of  hair,  a  profuse  perspiration,  and  a  cold  draught 
often  combines  effectively  to  produce  respiratory  disease. 

It  must  be  added  that  the  chilling  debilitates  the  nuclei  of  the 
animal  tissues,  and  les.sens  their  power  of  resistance  to'  noxious 
influences.  The  excess  of  cold  in  the  freezing  of  a  part,  is  fol- 
lowed by  congestion  and  even  violent  inflammation  with  perhaps 
sloughing  after  it  has  been  thawed.  The  persistence  of  such 
tissue  debility  is  familiar  to  us  all  in  the  example  of  chillblains. 
A  less  extreme  application  of  cold  affects  the  tissues  and  nuclei 
less  powerfully,  but  none  the  less  surely.  The  increased  liability 
to  disease  of  the  chilled  system  is  strikingly  illustrated  in  the  ex- 
periment of  Pasteur  with  anthrax.  The  chicken  which  had 
proved  refractory  to  an  ordinary  dose  of  anthrax  virus,  was 
dipped  in  water  at  ordinary  temperature  until  the  heat  of  its  body 
was  reduced,  and  then  it  fell  an  easj^  victim  to  the  anthrax 
bacillus.  In  the  same  way  the  person  who  recklessly  exposes 
himself  to  wet  and  chill  falls  a  ready  victim  to  intermittent  or 
yellow  fever  from  which  he  would  otherwise  have  escaped.  De- 
bility from  another  cause,  such  as  bruise  or  laceration,  favors 
deep-seated  invasion  by  pus  cocci,  and  a  resulting  abscess,  from 
which  the  patient  would  have  remained  free,  but  for  such 
traumatism. 

But  the  effect  of  cold  is  not  confined  to  the  sympathy  between 
the  skin  and  respiratory  mucous  membrane,  nor  the  revulsion  of 
the  blood   toward  internal  organs,  nor  to  the  debilitating  of  the 


Diseases  of  the  Respiratory  Organs.  75 

tissues.  The  application  of  cold  coustringes  the  vessels  and 
lessens  the  freedom  of  the  circulation  and  suppresses  the  normal 
cutaneous  exhalation.  A  somewhat  .similar  condition  may  be  in- 
duced by  prolonged  exposure  to  the  rays  of  a  burning  sun,  the 
skin  b2com2S  hot,  dry  and  rigid,  and  incompatible  with  the  main- 
tenance of  the  respiratory  function.  In  either  case  there  is  a 
retention  of  effete  and  deleterious  matters  in  the  circulation 
which  it  was  the  function  of  the  .skin  to  have  eliminated.  The 
danger  of  such  retention  may  be  be.st  exemplified  by  noting  the 
result  of  the  complete  repres.sion  of  perspiration  in  the  remarka- 
ble experiments  of  Fourcault  and  Bouley.  The  former  covered 
dogs  and  other  .small  animals  with  an  impermeable  varnish  which 
induced  death  after  some  days  or  in  some  cases  in  a  few  hours. 
Bouley  shaved  three  horses  and  covered  the  .skin  with  tar.  There 
resulted  dullness,  torpor,  deep,  slow  breathing,  weak  and  dimin- 
ishing pulse,  mu.scular  tremors,  manifest  cooling  of  the  body  and 
expired  air,  and  deep  violet  color  of  the  mucous  membranes. 
They  died  respectively  on  the  seventh,  ninth  and  tenth  days.  A 
fourth  horse  covered  with  a  layer  of  strong  glue  and  then  with 
tar  perished  nine  hours  after  the  application.  The  bodies  were 
like  those  of  animals  that  had  died  of  suffocation.  The  mucous 
membrane  of  the  stomach  and  bowels  was  gorged  with  black 
blood,  the  lungs  violently  congested — dark  red  and  heavy — the 
air-tubes  filled  with  frothy  material,  and  the  lining  membrane  of 
the  heart  had  dark  .spots  of  blood  extrava.sation.  It  is  no  longer 
then  matter  for  surprise  that  temporary  suppression  of  the  insen- 
sible perspiration  should  be  followed  by  diseases  of  the  chest  or 
abdomen,  that  extensive  burns  of  the  surface  of  the  body  should 
be  speedily  followed  by  inflammations  of  internal  organs  or  that 
extensive  and  .severe  cutaneous  inflammations  should  be  associated 
with  internal  lesions. 

Since  the  days  of  Hippocrates  it  has  been  universally  acknowl- 
edged that  moist  sea.sons  and  localities  are  less  salubrious  than 
dry  ones.  As  already  observed  moisture  in  a  cold  atmosphere 
inten.sifies  its  effect.  In  a  hot,  close  atmosphere  it  strongly  con- 
duces to  putrefaction  in  dead  organic  matter,  and  the  air  becomes 
loaded  as  a  con.sequence  with  noxious  gases,  and  in  its  lower 
strata  with  bacteria  in  a  .state  of  active  growth.     This  condition 


76 


Veterinary  Medicine. 


is  most  intense  in  close,  unventilated  stables,  and  manifestly 
operates  in  both  predisposing  to  and  exciting  those  diseases  of 
the  chest  and  other  parts,  so  frequent  in  such  places.  Winds  raise 
and  carry  such  germs,  but  also  sooner  rob  them  of  virulence. 
(See  Zymotic  Diseases).  Susceptible,  young  animals,  newly 
housed,  usually  suffer  the  most  severely  from  these  injurious  con- 
ditions. Often  in  their  case  frequent,  extreme  and  sudden 
changes,  and  great  atmospheric  impurity,  are  combined  with  a 
diet  to  which  they  have  been  hitherto  altogether  unaccustomed. 
In  young  horses  there  are  superadded  the  exertions — too  often 
extreme — connected  with  training  or  work.  There  are  the  heats 
and  chills,  the  soaking  perspiration  and  the  frigid  winds  and  rain, 
the  general  exhaustion,  but  particularly  the  overwork  of  the 
respiratory  organs,  each  of  itself  calculated  to  superinduce  disease. 
Percivall  justly  remarks  that  among  young  horses,  newly  stabled 
and  put  to  work,  the  prevailing  diseases  are  "catarrh,  sore 
throat,  strangles,  bronchitis,  pneumonia  and  pleurisy."  His 
tables  of  the  diseases  attacking  the  horses  of  his  own  regiment 
(ist  Ivife  Guards),  are  so  instructive  that  I  here  reproduce  them  : 


A  TABLE  (COMPILED  FROM  EXTRACTS  FROM  A  "REGISTER  OF  SICK  HORSES" 
LIMITED  TO  A  GIVEN  PERIOD)  SHOWING  THE  COMPARATIVE  AGES  AT 
WHICH  HORSES  APPEAR  MOST  DISPOSED  TO  CERTAIN  ORGANIC  DISEASES. 


No.  of 
Patients 
Under  5 

Years. 


No.  in 

Their  5th 

Year. 


5  Years     v  ears  ana 

and         Upwards 

Under  10.  ^ut  under 


No.  20 
Years  and;     Total. 
Upwards.' 


Disease  of  the  lungs 
Disease  of  the  bowels. 
Disease  of  the  brain 
Disease  of  the  eyes   . 


20  50 

40  j  70 

5  i  14 

70  I  35 


[Q  300 

20  1       J  60 

2  27 

5  !      150 


It  will  be  seen  that  nearly  one-half  of  the  sicknesses,  occurring 
among  the  horses  of  the  regiment,  were  chest  diseases,  and  that 
nearly  three-fourths  of  these  were  in  animals  under  five  j^ears 
old,  or  in  those  newly  purchased  from  the  country. 

The  subjoined  table  shows  the  relative  prevalence  of  disease  in 
different  months  of  the  year,  deduced  from  the  Register  above 
referred  to  : 


Diseases  of  the  Respiratory  Orgatis. 


77 


Disease  of  the 
IvUngs. 


Disease  of  the    Disease  of  the    Disease  of  the 
Bowels.        I  Brain.  Eyes. 


January  .  . 
February .  . 
March .  .  . 
April  .  . 
May  ... 
June  . 

July.  .  .  . 
August  .  . 
September . 
October  .  . 
November  . 
December  . 


Totals 


208 


35 


r35 


In  thi.s  table  the  extraordinary  prevalence  of  lung  diseases  in 
spring  and  autumn  is  very  noticeable.  There  only  remains  to 
notice  the  number  of  deaths  occurring  in  the  same  regiment  from 
pulmonary  and  other  di.seases. 

Deaths  from  pulmonary   disease 77 

Deaths  from  other  diseases  (Glanders  and  Farcy 

and  accidents  excepted) 57 

It  is  thtis  seen  that  though  individually  less  dangerous  than 
many  affections  of  the  abdomen,  brain,  etc.,  yet  by  reason  of  their 
greater  frequency  chest  diseases  induce  the  greatest  mortality 
among  this  class  of  stock. 

In  treating  of  the  diseases  of  this  class  of  organs  they  will  be 
sub-divided  according  as  they  affect  the  Jiose,  the  throat,  the 
neck,  and  the  chest. 


DISEASES  OF  THE  NOSE. 

EPISTAXIS.       BLEEDING  FROM  THE  NOSE. 

Epistaxis  as  a  primary  and  secondary  affection.  Causes — mechanical, 
over  exertion,  blood  pressure,  new  formations,  diseased  mucosa,  disease  of 
the  nasal  venous  plexus,  disease  of  heart  or  lungs,  in  blood  diseases,  in 
hsemorrhagic  constitution,  in  bacteridian  diseases  of  the  respiratory  organs. 
Symptoms.  Often  one  nostril,  blood  bright,  red,  clotted,  sneezing,  (not 
retching,  acid,  nor  cough).  Treatment.  Mechanical,  astringent,  cold, 
plugging  in  solipedes  and  other  animals  :  haemostatics. 

As  a  primar}'  affection  this  occurs  more  freqtiently  in  the  horse 
than  in  any  other  domestic  animal,  though  as  a  symptomatic  dis- 
ease .it  is  common  in  all  farm  animals. 

Causes.  The  most  common  causes  are  mechanical  injury  of 
the  Schneiderian  membrane,  violent  congestion  of  this  membrane 
during  extraordinary^  excitement  or  exertions,  as  in  coughing,  in 
a  closely  contested  race,  in  a  trying  hunt,  in  drawing  heavy 
loads,  cspeciall}'  if  uphill  and  with  a  tight  collar.  It  may  coin- 
cide with  congestion  of  the  brain  acting  to  some  extent  as  a  vica- 
rious discharge,  or  with  the  formation  of  new  structures  as  poly- 
pus, or  cancer,  in  which,  from  the  looseness  and  friability  of  their 
texture,  the  vessels  readily  give  way.  The  softened  membrane  is 
equally  liable  to  laceration  or  rupture  during  the  progress  of  in- 
flammation and  particularly  when  fibrinous  (croupous)  exudations 
arebiing  detached.  In  all  thes2  cases  animals  of  a  strong,  vigor- 
ous constitution  and  with  a  full  or  plethoric  habit  are  most  liable 
to  be  attacked.  Various  congestions  of  the  mucosa  in  diseases  of 
the  heart  or  lungs  are  additional  causes.  Disease  or  injury  of 
the  cervical  branch  of  the  sympathetic  nerve,  and  varicosity  of  the 
pituitary  venous  plexus  must  be  accepted  as  occasional  causes. 

Epistaxis  is  also  met  with  in  states  of  general  weakness  and 
with  deteriorated  blood,  as  in  anaemia,  in  the  course  of  various 
fevers  and  in  those  hemorrhagic  constitutions  in  which  the  altered 
blood  appears  to  find  an  easy  passage  through  the  debilitated  or 
ruptured  coats  of  the  bloodvessels.  Thus  it  is  seen  in  the  so- 
C3\\&d  purpura  hemorrhagica  in  the  horse,  in  small-pox  in  sheep, 
78 


Diseases  of  the  Nose.  yg 

in  anthrax,  and  in  szai?ie  piaoue  and  hog  cholera,  //eri  fig  records 
the  case  of  a  number  of  pigs  suffering  from  a  scorbutic  affection 
and  which  bled  profusely  from  the  nose.  In  bleeders  (haemo- 
philia; and  in  leucocythaemia  it  is  liable  to  appear. 

The  ulcerations  of  the  mucous  membrane  occuring  in  glanders 
and  chrojuc  catarrh  have  proved  exciting  causes  of  the  hemorrhage. 
Lastly  the  intense  heats  of  summer  and  prolonged  exposure  to 
the  direct  rays  of  the  sun  induce  a  general  relaxation  and  a  deter- 
mination of  blood  to  the  surface  which  rouses  to  activity  the  lat- 
ent tendency. 

Symptoms.  The  bleeding,  usually  from  one  nostril  only,  falls 
in  a  succession  of  drops,  (rarely  in  a  stream),  collects  in  clots 
around  the  nostril,  and  bespatters  surrounding  objects  as  it  is  ex- 
pelled forcibly  in  sneezing.  It  is  usually  of  a  bright  crimson  hue 
or,  in  fevers  or  poisoned  conditions  of  the  blood,  of  a  dark  or 
blackish  color.  It  is  distingui.shed  from  pulmonarj-  hemorrhage 
by  the  absence  of  cough  and  of  a  frothy  condition,  and  from 
bleeding  from  the  stomach  by  the  absence  of  the  blackened  clots 
and  acid  odor  which  indicate  the  presence  of  the  gastric  juice. 

It  is  usually  to  be  further  distinguished  from  these  in  all  ani- 
mals, save  .solipedes,  by  the  absence  of  blood  in  the  mouth. 

Treatment.  Nasal  hemorrhage  often  stops  spontaneously,  but 
if  the  discharge  is  profuse  or  long  continued,  and  especially  in 
weak  or  ansemic  conditions  it  must  be  treated  energetically.  Care 
should  be  taken,  however,  to  ascertain  first,  whether  it  is  not 
vicarious  of  some  other  and  more  dangerous  condition  like  cere- 
bral congestion. 

The  head  should  be  placed  in  an  elevated  position  by  tying  it 
up  to  the  rack,  and  cold  water  or  ice  kept  applied  over  the  head 
and  neck.  Matico  powder  may  be  blown  into  the  affected  nostril 
during  inspiration,  or  a  solution  of  alum  (4  drachms  to  i  pint  of 
water)  or  other  astringent  may  be  thrown  in  by  means  of  a 
syringe.  A  tablespoonful  of  peroxide  of  hydrogen  thrown  into 
the  nose  with  an  ordinary  syringe  will  give  immediate  relief. 
(Gillette.) 

Plugging  the  affected  nostril  with  a  pellet  of  tow  covered  with 
matico,  tannin,  tincture  of  chloride  of  iron  (i:io  or  20)  or  other 
astringent  may  be  employed  when  other  means  fail.  By  means 
of  a  cord  attached  to  the  plug  it  may  be  withdrawn  after  all  dan- 


8o  lacier inary  Medicine. 

ger  is  past.  In  solipedes,  if  both  nostrils  must  be  plugged,  wrap 
the  tow  around  two  elastic  caouchouc  tubes  and  introduce  these, 
or  in  the  absence  of  these  perform  tracheotomy. 

Any  tendency  to  recurrence  may  be  met  by  the  internal  admin- 
istration of  gallic  acid  (horse  and  cow  J^ — i  drachm),  acetate  of 
lead  (horse and  cow  Y2  —  i  drachm)  or,  in  ansemic conditions,  tinc- 
ture of  the  perchloride  of  iron  (horse  and  cow  ^-3  oz.)  in  water. 


RHINITIS.     CORYZA.      NASAL    CATARRH.      COLD    IN 
THE    HEAD. 

Coryza  in  the  horse  :  Causes,  wet,  cold  after  perspiration,  damp  climate, 
stable,  soil,  new  buildings,  hygroscopic  building  materials,  youth,  age, 
poverty,  nervous  sympathy,  local  irritants,  iodine,  specific  disease  poisons. 
Symptoms,  dry  congestion,  watery  discharge,  muco-purulent  discharge, 
eyes  involved,  chill,  fever,  circulatory  and  breathing  disturbance,  defeca- 
tion, urine,  glandular  swelling.  Inflammation  of  the  sinuses,  the  severe 
effects.  Duration  in  slight  cases,  in  severe,  in  sinus  complication.  Treat- 
ment, hygienic,  nursing,  dietary,  steam,  sulphur  dioxide,  febrifuges,  in- 
sufflation, electricity,  solvent,  antiseptic,  stimulant. 

Under  this  head  will  be  considered  simple  inflammation  of  the 
nasal  mucous  membrane.  This  disease  might  be  considered  as  a 
mild  febrile  affection  with  the  local  manifestation  in  the  nose,  but 
it  is  more  convenient  to  treat  of  it  here  as  a  malady  of  the  nasal 
chambers. 

CORYZA    IN   THE    HORSE. 

The  chief  causes  are  exposure  to  wet  and  cold  and  especially 
when  the  subject  is  exhausted  and  the  skin  relaxed  and  covered 
with  perspiration.  In  these  circumstances  a  piercing  wind,  a 
cold  drizzling  rain,  or  a  draught  in  the  stable  is  particularly  dan- 
gerous. Sudden  alternations  of  temperature  and  especially  a 
change  to  a  warm  stable  when  the  general  effect  is  aggravated  by 
the  impurity  of  the  atmosphere  and  the  irritant  emanations  from 
dung  and  urine.  Damp  climates  are  more  injurious  than  those 
that  are  clear,  dry,  and  bracing,  and  so  are  equally  damp  stables 
whether  the  moisture  is  due  to  the  nature  of  the  soil,  such  as  a 
cold  impervious  and  undrained  clay,  or  of  the  building  which, 
from  its  newness,  may  retain  a  dangerous  amount  of  moisture  in 
the  plaster,  or  because  of  the  hygroscopic  properties  of  the  build- 
ing materials  which  draw  moi.sture  from  the  surrounding  soil. 
It  mainly  attacks  young  horses  after  they  have  passed  out  of  the 
hands  of  the  breeder  or  dealer,  and  have  been  placed  in  new  con- 
ditions of  life  alike  as  regards  feeding,  stabling  and  work.  Old 
and  ill-conditioned  animals  are  more  susceptible  than  the  strong 
.      fi  8i 


82  Veterinary  Medicine. 

and  vigorous,  and  the  changes  of  the  coat  in  spring  and  autumn 
prove  strong  predisposing  causes.  Nervous  causes  are  potent  in 
causing  engorgement  of  the  erectile  tissue  covering  the  turbinated 
bones,  and  local  irritants,  like  septic  dust,  lime,  ipecacuanha,  pollen 
of  certain  plants,  smoke,  and  irritating  fogs  may  precipitate  it. 
Iodine  in  large  doses  produces  temporary  catarrh.  The  weakness 
of  the  mucosa  from  a  previous  attack  predisposes  to  a  second. 
Occasionally  the  disease  sweeps  over  a  country,  as.suming  the 
form  of  an  epizootic  when  it  may  perhaps  be  preferably  con- 
sidered as  a  catarrhal  fever,  strangles  or  mild  type  of  injlueiiza, 
which  see. 

Symptoms.  \\\W\q.  milder  forms  oi  coryza  the  symptoms  may 
be  almost  exclusively  local,  consisting  in  redness  and  dryness  of 
the  membrane  lining  the  nose  and  sneezing,  .soon  followed  by  the 
bilateral  discharge  of  a  thin  transparent  watery  liquid,  succeeded 
by  a  turbid  flow  (epithelial  cells  in  excess)  and  after  two  or  three 
days  by  a  thick,  white,  flocculent,  puriform  fluid  (suppuration 
diapedesis).  With  the  supervention  of  the  purulent  discharge, 
comes  an  abatement  of  the  local  inflammation  and  the  freer  the 
discharge  the  greater  usually  is  the  relief  obtained  and  the  more 
rapid  the  recovery.  The  eyes  are  usually  red'  and  watery  and 
sometimes  the  eyelids  are  swollen.  This  implies  the  continuity 
of  the  inflammation  through  the  lachrymo-nasal  duct,  and  the 
obstruction  to  the  flow  of  tears  into  the  nose. 

When  constitictional  disturbance  exists  a  rough  or  staring  coat 
appears  as  one  of  the  first  symptoms,  the  sneezing  is  more  violent, 
the  nasal  mucous  membrane  is  more  reddened  and  swollen,  the 
eyes  more  dull,  sunken  and  watery,  the  mouth  hot  and  clammy, 
the  tempei'ature  of  the  body  raised,  the  pulse  more  frequent  and 
having  a  sharper  beat,  the  impulse  of  the  heart  may  often  be  felt  by 
applying  the  hand  to  the  chest  just  behind  the  left  elbow,  the  ap- 
petite is  fastidious  and  the  secretions  of  the  bowels  and  icidneys  are 
diminished,  the  latter  being  denser  and  more  highly  colored,  from 
the  absorption  of  irritating  or  infecting  matters  the  glands  under  the 
throat  are  swollen  and  the  swelling  of  the  mucous  membrane  may 
be  such  as  to  impair  breathing  and  even  to  threaten  suffocation. 
In  severe  cases  in  which  the  inflammation  extends  to  the  nasal 
sinuses  there  is  heat  and  tenderness  over  the  forehead  and  the 
pain  and  weight  are  manifested  by  the  pendent  head  and  the  red 


Rhinitis.      Coryza.     Nasal  Catarrh.      Cold  in  the  Head.      83 

sunken,  watery  eyes  and  tumefied  eyelids.  When  it  extends  to 
the  throat,  the  cough,  the  difficulty  in  swallowing  and  the  local 
tenderness  on  handling  are  characteristic. 

Course.  With  the  occurrence  of  suppuration,  improvement 
commences  and  if  the  inflammation  does  not  extend  beyond  the 
nasal  chambers,  and  if  it  is  not  kept  up  by  a  repetition  or  con- 
tinuance of  the  cause  the  disease  will  have  terminated  in  recovery 
in  eight  or  ten  days.  For  ulterior  consequences  in  bad  cases  see 
chronic  catarrh,  conjiuictivetis,  abscess  of  the  nasal  sinuses,  laryn- 
gitis, stomatitis,  staphylitis. 

Treatment.  In  slight  cases  the  simplest  treatment  only  is  re- 
quired. Place  the  animal  in  a  dry,  airy,  loose  box,  clear  of 
draughts,  and  with  uniform  temperature  of  55°  to  60°  Fah,,  if 
obtainable.  In  the  cold  season  blanket  warmly,  and  hand-rub 
and  loosely  flannel  bandage  the  legs.  Feed  on  sloppy  bran  mashes 
only  and  add  half  an  ounce  to  an  ounce  of  powdered  nitrate  of 
potash  daily.  Give  fresh  water  ad  libitum,  solicit  the  action  of 
the  bowels  b}^  giving  injections  of  warm  water  three  times  a  day, 
and  encourage  the  nasal  discharge  by  causing  the  patient  to  in- 
hale steam  for  half  an  hour  or  an  hour  twice  daily.  This  may  be 
done  by  giving  scalded  bran  in  a  nose-bag  or  by  keeping  the  head 
over  a  bucket  containing  hay  with  boiling  water  poured  over  it, 
the  steam  being  meanwhile  directed  by  a  bag  open  at  both  ends 
one  of  which  is  fixed  around  the  animal's  nose  and  the  other 
round  the  mouth  of  the  bucket.  As  a  local  astringent,  tonic  and 
antiseptic  the  fumes  of  sulphur  (burned  behind  the  animal  and  no 
more  concentrated  than  can  be  breathed  with  comfort)  will  do 
much  to  cut  short  the  attack.  It  is  more  soothing  if  combined 
with  steam.  Shut  doors  and  windows,  add  a  few  drops  of  alco- 
hol to  some  pinches  of  sulphur  and  burn  on  paper  laid  on  a  clean 
shovel  or  piece  of  sheet  iron,  When  enough  has  been  used  ex- 
tinguish by  covering  with  a  cup  or  other  object.  Repeat  several 
times  a  da3^  Under  this  treatment  recovery  may  be  completed  in 
three  or  four  days. 

In  severe  cases  attended  with  fever,  besides  the  above  a  dose  of 
laxative  medicine  may  be  given  (three  or  four  drachms  of  aloes), 
with  this  precaution,  that  if  the  fever  is  of  a  low  type  or  the 
malady  epizootic,  half  the  dose  only  can  be  safely  allowed  (2  dr.) 
on  account  of  the  danger  of  superpurgation.       The  nostrils  must 


84  Veterinary  Medicine. 

be  more  assiduously  steamed  and  linseed  tea  may  advantageously 
replace  fresh  water  as  a  beverage.  If  there  is  much  sv^^elling  and 
tenderness  of  the  glands  a  poultice  should  be  applied  to  the 
throat  and  between  the  jaws,  and  sulphur  fumes  as  advised  above, 
or  anodyne  astringent  insufflation  powder  may  be  resorted  to. 
Morphia  chlorate  two  grains,  bismuth  nitrate,  six  drachms  and 
finely  powdered  gum  arable  three  drachms  may  be  blown  into  the 
nostril  during  inspiration,  or  the  astringent  anodyne  injection 
advised  below  for  chronic  catarrh  may  be  used.  Cocaine  spray 
is  often  very  helpful,  or  the  same  agent  may  be  used  in  the  liquid 
form  on  cotton  wool  inserted  in  the  nasal  chamber.  If  this  is 
without  effect  a  weak  continuous  current  of  electricity  will  cause 
constriction  and  give  prompt  relief.  It  may  be  repeated  every 
few  hours.  In  the  absence  of  this  the  emanations  from  a  weak 
solution  of  ammonia  or  from  carbonate  of  ammonia  may  be  used. 
In  cases  with  excessive  and  persistent  muco-purulent  discharge, 
with  presumptive  infection  from  outside  sources,  or  in  the  young, 
from  the  diseased  maternal  passages,  insufflation  with  calomel, 
painting  with  a  two  grains  to  the  ounce  solution  of  nitrate  of 
silver,  or  injection  with  some  other  germicide  may  be  resorted  to. 
In  case  the  fever  is  of  a  low  type,  liquor  of  the  acetate  of  am- 
monia (4  ozs.),  sal-ammoniac  (^  oz.),  or  even  carbonate  of  am- 
monia {yT,  oz.),  may  be  given  several  times  a  day,  with  sweet 
spirits  of  nitre  (>^  oz.)  and  tincture  of  gentian  (i  oz.)  Alco- 
holic stimulants  are  often  used.  Inhalations  of  iodine  and  iodide 
of  potassium  with  ether  and  chloroform  are  often  successful. 


SIMPLE  CORYZA  IN  CATTLE. 

Coryza  mild  in  cattle.  General  treatment.  Coryza  in  sheep  from  expo- 
sure, intemperate  seasons,  clipping.  Acute  and  chronic.  Wholesale  treat- 
ment in  flocks.  Coryza  in  pigs.  Coryza  in  dogs,  simple,  secondary. 
Treatment,  food,  laxative,  febrifuge,  nauseating,  expectorant,  antiseptic, 
gaseous,  electric. 

This  is  usually  a  very  simple  malady  when  confined  to  the 
nasal  chambers,  and  not  of  infective  origin.  When,  on  the 
other  hand,  it  attacks  the  sinuses  it  becomes  a  disease  of  extreme 
gravity.  (See  Catarrh  of  the  Sinuses).  Symptoms  are  as  seen  in 
the  horse,  but  the  discharge  may  be  overlooked  because  of  the 
animal  licking  it  out  with  his  tongue.  Treatment  does  not  essen- 
tially differ  from  that  laid  down  above,  and  recovery  may  be  ex- 
pected in  seven  or  eight  days.  If  a  laxative  is  wanted  give  from 
one  to  two  pounds  Epsom  salts. 

SIMPLE    CORYZA   IN   SHKEP. 

Coryza  is  usually  slight  and  is  manifested  by  sneezing  and  run- 
ning from  the  nose.  It  occurs  in  animals  clipped  or  badly  shel- 
tered during  the  more  inclement  seasons.  In  the  worst  cases  the 
discharge  becomes  persistent  and  emaciation  ensues  so  that  it  is 
necessary  to  interfere.  Valuable  animals  may  be  treated  on  the 
same  principles  as  oxen,  and  in  the  case  of  large  flocks  by  shelter 
in  a  warm,  dry,  cleanly  and  airy  place  and  fumigations  of  steam 
and  the  fumes  of  burning  sulphur  repeated  daily,  together  with 
nourishing  diet,  such  as  boiled  barley  or  other  grain,  and  quarter 
ounce  doses  of  nitre  and  common  salt. 

CORYZA    IN   THE   PIG. 

Hogs  are  not  very  subject  to  this  disease  and  are  easily  treated 
by  warm,  sloppy  food,  and  as  a  laxative  three  or  four  croton 
beans,  according  to  size,  powdered  and  given  in  the  aliment. 

CORYZA    IN    DOGS. 

Dogs  are  rarely  the  subjects  of  simple  coryza,  though  it  is 
constant  in  distemper.     It  sometimes  proves  troublesome  in  pup- 

85 


86  Veterinary  Medicine. 

pies  and  old  dogs.  A  laxative  (>^ — i  ounce  castor  oil)  may  be 
followed  in  strong  and  v^ery  feverish  cases  by  tartar  emetic  {% — 
^  grain)  three  times  a  day.  Spraying  or  sponging  the  nose  with 
a  weak  solution  of  chlorate  of  potass,  common  salt,  or  potassium 
permanganate  \\\\\  greatly  relieve.  Inhalation  from  burning  sul- 
phur, or  from  carbonate  of  ammonia,  or  both  may  be  used  when 
sponging  or  spraying  is  diflQcult.  In  inveterate  cases,  the  weak 
electric  current  sent  through  the  cheeks,  or  the  insufflation  of 
acetanilid,  iodoform  or  calomel  may  be  tried.  As  a  rule,  salt- 
peter in  five  grain  doses,  given  in  the  water,  will  prove  helpful, 
and  in  weak  conditions  wine,  tincture  of  gentian  or  nux-vomica 
may  be  used. 


CHRONIC  NASAL  CATARRH.     NASAL  GLEET. 
OZCENA  IN  THE  HORSE. 

Chronic  catarrh  in  horse,  simple  form,  loss  of  tone,  inflammation,  nature 
of  discharge,  glandular  swellings,  differentiation  from  glanders.  Treat- 
ment, astringent,  tonic,  stimulant,  hygienic,  locally  astringents,  antiseptics, 
injections. 

A  chronic  discharge  from  the  no.se  is  often  seen  in  the  horse  as 
a  sequel  of  coryza  or  sore  throat,  or  as  an  attendant  on  other 
affections  of  the  upper  air-passages,  and  the  different  conditions 
productive  of  this  SN-mptom  may  here  be  noticed. 

1ST.    SIMPLE    NASAL    CATARRH.       XASAL    GLEET.       OZCENA. 

In  long  standing  coryza  the  nasal  mucous  membrane  becomes 
relaxed,  fails  to  acquire  its  lost  tone  and  continues  to  pour  out  a 
mucopurulent  product.  This  is  really  a  persistence  of  inflamma- 
tion of  a  low  type,  under  the  influence  of  which  the  membrane 
secretes  pus  in  place  of  its  normal  mucus.  The  discharge  is 
white,  thick,  creamy,  has  little  tenacity,  and  flows  uninterrupt- 
edly. There  may  be  slight  enlargement  of  the  submaxillary 
glands,  and  if  the  case  is  of  long  standing  and  the  patient  in  low 
condition  sores  maj'  appear  on  the  raucous  membrane.  The.se 
ulcers  are  di.stinguished  from  those  of  glanders  by  the  absence  of 
the  unhealthy  angry  aspect  and  excavated  borders  of  the  latter, 
by  the  absence  of  the  small  nodular  deposits  on  the  mucosa,  by  the 
less  viscid  natttre  of  the  secretion,  and  by  the  absence  of  submaxil- 
lary swellings,or  if  the.se  exist,  by  their  being  less  nodular,  less  in- 
durated and  le-ss  firmly  attached  to  surrounding  parts.  The  coinci- 
dence of  ulcers  and  submaxillary  .swellings  is  always,  however,  mat- 
ter for  the  gravest  suspicion,  and  such  cases  should,  as  a  rule,  be 
subjected  to  the  mallein  test.      (See  Glanders  and  Farcy). 

Treatynent.  In  simple  nasal  catarrh,  due  alone  to  the  relaxation 
of  the  mucous  membrane,  the  internal  use  of  tonics  and  the  local 
application  of  astringent  solutions  to  the  nose  rapidly  restore  the 
parts  to  a  healthy  state. 

Among  stimulants,  cubebs,  cayenne  pepper  and  copaiba  have  a 


88  Veterinary  Medicine. 

stimulating  and  styptic  effect  on  the  mucous  membrane  and  each 
of  these  has  been  successfully  used  in  such  cases.  Cantharides, 
in  five- grain  doses,  have  proved  even  more  successful,  (Vines, 
Percivall) .  Sulphate  of  Copper  in  drachm  doses  in  mucilage  night 
and  morning  has  proved  very  efficient  (Sewell,  Percivall).  Arsen- 
iotis  Acid  has  been  employed  with  still  better  results.  The  dose, 
of  five  grains  may  be  intimately  mixed  with  a  scruple  of  bicar- 
bonate of  soda  and  given  daily  in  food.* 

But  the  most  efficient  tonic  in  these  cases  is  arseniate  of 
strychnia.  Its  good  effects  may  be  secured  by  combining  with 
the  above  mentioned  powders  of  arsenious  acid  and  bicarbonate 
of  soda,  half  a  drachm  of  powdered  nux  vomica  for  each  dose.f 
These  powders  will  usually  be  taken  in  food,  and  may  be  contin- 
ued for  a  month,  or  until  the  discharge  ceases. 

In  all  cases  the  general  health  must  be  carefully  attended  to. 
Keep  the  patient  in  a  dry,  clean,  airy  building  without  draughts 
of  cold  air  ;  give  moderate  exercise  in  the  open  air  ;  and  good 
grooming  ;  and  allow  nutritious  food  of  mildly  laxative  properties, 
— as  occasional  bran  mashes  and  roots  in  winter  and  succulent 
gra.sses  in  summer. 

Local  Applications.  These  are  the  most  important  remedial 
measures  and  usually  of  themselves  succeed  in  reestablishing  a 
healthy  condition. 

The  agents  proving  most  useful  are  of  an  astringent  nature  and 
in  obstinate  cases  one  may  be  substituted  for  another  as  the  last 
appears  to  lose  its  effect.  Sulphate  of  Zinc  or  Sulphate  of  Copper 
in  the  proportion  of  half  a  drachm  of  either  to  a  quart  of  water, 
may  be  used,  or  if  there  is  much  foetor,  a  solution  containing  a 
drachm  each  of  carbolic  acid  and  carbonate  of  potash  in  a  quart  of 
water  is  to  be  preferred.     In  either  case  the  addition  of  an  ounce 


*In  giving  this  agent,  any  redness  or  watering  of  the  eyes,  or  colicy  pain 
should  be  carefully  watched  for,  and  when  these  premonitory  symptoms  of 
poisoning  are  noticed  the  medicine  should  be  at  once  suspended  to  be  com- 
menced a  few  days  later  in  smaller  doses. 

t  Whenever  nux  vomica  or  its  alkaloids,  strychnia  or  brucia,  are  given,  in- 
creased irritability  and  nervousness  should  be  carefully  watched  for  and 
especially  any  involuntary  twitching  of  the  muscles.  On  their  appearance 
the  agent  must  be  suspended  and  commenced  a  few  days  later  in  half  the 
former  doses. 


Chronic  Nasal  Cataorh.  Nasal  Gleet.    Oza^na  in  the  Horse.     89 

of  pure  glycerine  renders  the  lotion  at  once  more  soothing  and 
more  efficient.  The  solution  must  be  rendered  tepid  before  in- 
jecting it,  to  obviate  the  irritation  attending  on  the  contact  of  a 
cold  fluid  with  the  delicate  membrane  of  the  nose.  Among  other 
agents  may  be  named  creolin,  creosol,  creosote,  acetate  of  lead, 
potassium  permanganate,  and  .silver  nitrate.  Peroxide  of  hydro- 
gen may  be  used  either  as  injection  or  in  spray. 

The  mode  of  injection  is  a  matter  of  no  small  moment.  It  has 
been  done  in  some  instances  by  means  of  a  large  syringe  but  the 
irritation  attendant  on  such  a  process  is  an  insuperable  objection 
to  its  use.  A  better  instrument  is  that  introduced  by  Profes.sor 
Rey  of  Lyons.  It  consists  in  a  tube  bent  on  itself  at  an  angle  of 
35"  .so  as  to  form  two  arms  of  inequal  lengths.  The  longer  fif- 
teen inches  in  length,  one  and  a  half  in  diameter  and  widening 
into  a  funnel  at  its  free  end  ;  —the  shorter  about  five  inches  long 
and  tapering  towards  its  free  end  where  its  aperture  is  only  two- 
thirds  of  an  inch  across.  The  instrument  is  made  of  block  tin  or 
extemporaneously  of  gutta  perclia.  Over  the  shorter  arm  is 
placed  a  tightl}'  fitting  leather  ring  four  and  a  half  inches  in  di- 
ameter on  which  is  applied  some  wet  tow  to  adapt  it  to  the  no.stril 
and  effectually  close  it.  The  nose  having  been  drawn  in  .so  as  to 
place  the  head  in  a  vertical  position,  the  short  arm  of  the  instru- 
ment is  introduced  into  the  affected  nostril,  and  the  liquid  being 
gently  poured  into  the  long  arm  rises  slowly  in  the  nose  until  it 
is  filled  and  the  liquid  flows  from  the  nostril  on  the  opposite  side. 
In  introducing  the  tube  care  must  be  taken  that  it  may  not  irritate 
the  inner  wall  of  the  nose  on  the  one  hand,  nor  pass  into  the 
blind  pouch,  known  as  \.\\q.  false  nostril,  on  the  other. 

The  greatest  gentleness  and  tact  are  requisite  in  thus  injecting 
the  nostrils,  though  in  troublesome  animals  it  is  sometimes  neces- 
sary to  resort  to  blindfolding  or  even  to  the  application  of  a  twitch 
on  the  ear,  or  finally  to  strapping  the  animal  (head  included)  to  a 
smooth  firm  vertical  surface  (operating  table). 


COLLECTION  OF  PUS  IN  THE  NASAL  SINUSES. 

Nasal  Siiuises,  position,  orifice,  suppuration,  symptom?,  treatment,  tonics, 
astringents,  antiseptics,  trephining,  significance  of  the  fcetor,  mode  of  re- 
covery. 

In  severe  corysa  the  nasal  sinuses  become  implicated  as  shown 
by  the  intensity  of  the  symptoms,  the  prostration,  the  hanging 
head,  and  the  heat  and  sometimes  tenderness  between  the  eyes 
and  immediately  beneath  them  on  the  side  of  the  upper  jaw. 
These  sinuses  are  large  spaces  filled  with  air,  situated  between  the 
superficial  and  deep  plates  of  the  bones  of  the  face  and  opening 
into  the  nostrils  by  a  narrow  orifice  in  the  upper  part  of  the  nasal 
chambers.  When  pus  is  largely  formed  in  these  it  fails  to  flow 
out  as  rapidly  as  produced,  parts  with  a  portion  of  its  liquid  ele- 
ments, increases  in  consistency  and  sometimes  even  undergoes  de- 
composition, so  that  the  discharge  from  the  nostril  has  a  putrid 
odor. 

The  most  distinctive  symptoms  of  this  form  of  nasal  gleet  are 
obtained  by  percussing  the  sinuses,  and  in  those  cases  in  particu- 
lar in  which  the  accumulation  is  confined  to  one  side  of  the  head, 
the  contrast  between  the  two  sides  is  unmistakable.  By  gently 
tapping  the  forehead  with  the  middle  finger  from  one  eye  to  the 
other  the  flat  solid  sound  on  the  diseased  side  is  easily  distinguished 
from  the  clear  drum-like  resonance  on  the  healthy  one.  By  tap- 
ping on  the  bone  beneath  each  eye  and  just  above  the  -ridge  on  the 
side  of  the  upper  jaw,  the  difference  between  the  two  sides  will  be 
recognized  in  the  same  way.  In  some  old-standin'g  cases  increas- 
ed tenderness  and  slight  bulging  of  the  bones  over  the  affected 
sinuses  are  often  superadded  to  the  other  symptoms.  The  eye  on 
the  affected  side  is  usually  retracted  so  as  to  seem  smaller. 

Ti'eatment.  In  some  cases  the  use  of  tonics  and  astringent  in- 
jections as  recommended  for  thetreatm2nt  of  ozoenav^WX  prove  suc- 
cessful, but  more  usually  it  is  needful  to  open  and  inject  the  si- 
nuses. 

For  this  the  following  articles  are  required  :  scissors,  a  knife, 
forceps,  a  trephine  or  circular  saw  from  half  to  three-fourths  of  an 
inch  in  diameter  and  a  whalebone  or  metallic  prob. 
90 


Collect io7i  of  Pus  in  the  Nasal  Sinuses.  91 

The  horse  is  thrown  and  made  fast  with  the  diseased  side  of  the 
head  uppermost.  A  point  is  then  selected  on  a  Hne  drawn  between 
the  centres  of  the  two  eyeballs  and  an  inch  to  one  side  the  median 
line  of  the  forehead  ;  the  hair  is  closely  removed  with  the  scissors, 
and  a  semi-circular  flap  of  skin  over  an  inch  in  diameter  is  dis- 
sected from  the  bone  and  turned  back  toward  the  poll.  The  tre- 
phine is  next  applied  on  the  bone  and  a  circular  portion,  having 
been  cut  through,  is  pulled  out  by  the  forceps,  when  the  imprison- 
ed pus  will  commonly  ooze  from  the  opening.  A  second  point  is 
chosen  just  above  the  lower  end  of  the  bony  ridge  of  the  upper 
jaw  already  referred  to  and  opposite  the  third  molar  tooth,  count- 
ing from  before  ;  the  hair  is  removed  as  before,  a  flap  of  the  skin 
raised  upward  and  backward  and  the  bone  trephined  to  open  the 
second  sinuse.  The  point  of  election  for  this  orifice  is  more  im- 
portant than  that  of  the  first.  If  it  is  too  near  the  eye  the  lower 
part  of  the  sinus,  which  is  separated  from  the  upper  by  an  imper- 
forate bony  plate,  is  not  opened  and  may  continue  to  keep  up  the 
discharge  from  the  nose.  If  on  the  contrary  it  is  made  too  low 
down,  the  lower  sinuse  only  is  opened  and  the  upper  being  im- 
perfectly washed  out  from  the  wound  in  the  forehead  will  keep  up 
the  discharge.  Either  then  this  plate  must  be  struck  with  the 
trephine  or  it  must  be  afterward  perforated  to  secure  a  favorable 
result.  Theprob  introduced  by  the  wound  in  the  forehead  should 
further  appear  at  the  lower  orifice. 

The  cavities  are  to  be  washed  out  first  with  clear  tepid  water, 
and  thereafter  daily  with  an  astringent  solution  such  as  that  used 
for  injecting  the  no.se.  If  the  discharge  does  not  escape  freely  by 
the  lower  orifice  its  exit  may  be  facilitated  by  drawing  a  tape 
through  the  sinuses,  from  the  upper  to  the  lower,  and  retaining  it 
there  by  a  knot  on  each  end. 

Marked  fcetor  of  the  wound  will  usually  indicate  necrosis  at  the 
edge  of  the  wound,  and  demands  the  use  of  bone  forceps  or  chisel 
to  remove  the  offending  bone. 

A  cure  is  affected  by  the  restoration  of  the  membrane  to  its  nat- 
ural state,  or  in  other  cases  by  the  filling  up  and  obliteration  of 
the  cavity  by  granulation. 


ABSCESS  OF  THE  FAI.SE  NOSTRIL   OR   TURBINATED 
BONES. 

Structure  of  turbinated  bones  :  suppuration  or  abscess,  obstructed  breath- 
ing, treatment,  puncture,  plugging,  injection,  trephining. 

The  turbinated  bones  are  two  fragile  bony  structures  attached 
to  the  outer  wall  of  each  nasal  chamber.  The  posterior  half  of 
each  bone  closes  the  corresponding  nasal  sinuse ;  the  anterior 
half  is  rolled  upon  itself  as  a  sheet  of  paper  might  be,  and  is  ac- 
cordingly open  along  one  side.  In  this  latter  a  collection  of  pus 
may  result  from  severe  inflammatory  action  and  the  resulting  dis- 
charge may  become  somewhat  chronic.  The  flow  is  greatest  after 
the  nose  has  been  raised,  from  the  pus  having  previously  gravitated 
into  a  sac  in  the  lower  end  of  the  bone.  The  pus  may  moreover 
pass  backward  into  the  larnyx  from  the  raising  of  the  head  and 
induce  a  violent  fit  of  coughing.  Sometimes  the  inflammation 
has  extended  to  the  bones  covering  the  nose  which  are  bulging 
and  tender.  The  thin  turbinated  bone  gives  way  under  the  dis- 
tension, bulges  into  the  nose,  and  often  stops  the  passage  of  air 
through  that  side.  This  symptom  and  the  appearance  of  the 
swelling  cause  a  close  approximation  in  symptoms  to  nasal  poly- 
pus. The  facts  that  it  supervened  on  a  severe  coryza,  that  it  fluc- 
tuates on  pressure  if  within  reach  of  the  finger,  and  that  pus  es- 
capes when  it  is  punctured,  exclude  the  idea  of  polypus. 

Treatmeiit.  Puncture  of  the  abscess  inside  the  nose,  plugging 
and  dail}^  astringent  injections  will  usuall)'  rapidly  cure.  Gamgee, 
Jessen  and  others,  recommend  trephining  of  the  bone  above  the 
nose  and  washing  it  out  daily,  adding  that  an  extensive  removal  of 
the  bone  will  correct  any  existing  bulging  and  deformity. 


92 


NASAI.  DISCHARGE  FROM  CARIOUS  TEETH,  ETC. 

Ulceration  into  sinus  from  caries,  loss  of  molar,  overgrown  molar. 
Foetor,  tenderness.     Foreign  body  in  the  nose. 

In  cases  of  a  diseased  molar  tooth  in  the  upper  jaw,  food 
getting  firmly  impacted  in  the  hollow  space,  irritates  the  pulp  in 
the  fang  and  the  adjacent  bone  until  the  progress  in  ulceration 
reaches  the  nasal  chamber  or  sinuse  and  a  nasal  discharge  is 
established.  If  an  upper  molar  tooth  is  lost  the  molar  formerly 
opposed  to  it  in  the  lower  jaw  grows  out  and  sets  up  the  same 
train  of  symptoms.  In  all  cases  then  in  which  nasal  gleet  is  as- 
sociated with  much  foetor  and  with  difficulty  in  eating,  a  careful 
examination  of  the  teeth  should  be  made.  (See  Diseases  of  the 
Teeth). 

FOREIGN    BODY    IN   THE    NOSB. 

Professor  Gamgee  records  the  destruction  of  an  animal  for  glan- 
ders in  which  the  cause  of  the  discharge  was  afterwards  found  to 
be  a  physic  ball  coughed  up  into  the  posterior  part  of  the  nose 
and  firmly  impacted  there. 


93 


COLLECTIONS  OF  PUS  IN  THE  GUTTURAL  POUCHES. 

Structure,    position   and    opening   of  pouches,     inflamed   by   extension. 


pastur- 
landu- 


S}-mptonis,  discharge  intermittent  with  pendent  head,   swallowing,   p 
ing,  cough,  roaring,  dyspnoea,  inhalation  of  food,  parotid  swelling,  gl 
lar  enlargement.     Nature  of  contents.     Treatment,  pasturage,   blister,  ton- 
ics, irrigation,  puncture,  injection. 

Though  this  is  commonly  a  restilt  of  severe  sore  throat  or 
strangles,  yet  as  it  catises  a  chronic  discharge  from  the  no.se  liable 
to  be  confounded  with  those  properly  due  to  diseases  of  the  nasal 
chamber,  it  is  noticed  in  this  place. 

The  guttural  pouches  are  two  mucous  sacs  peculiar  to  solid 
footed  animals.  They  lie  .side  by  .side  above  the  throat,  and  in 
direct  contact  with  the  lower  surface  of  the  .superior  bones  of  the 
head  and  the  first  bone  of  the  neck.  They  are  properly  speaking 
dilatations  of  the  Eustachian  tubes  which  in  all  animals  establish  a 
communication  between  the  pharynx  and  the  middle  ear. 
The  opening  into  the  pharynx  is  at  the  anterior  extremity  of  the 
pouch  and  close  to  the  posterior  opening  of  the  nostril,  hence  the 
discharge  takes  place  chiefly  or  exclusively  when  the  head  is 
lowered,  since  gravitation  then  favors  the  escape  of  the  fluid. 

Frequently  implicated  in  severe  sorethroat  the  walls  of  the  gut- 
tural pouches  pour  out  pus  as  readily  as  other  mucous  membranes 
in  a  .state  of  inflammation.  As  the  escape  of  this  product  is  hin- 
dered alike  by  the  narrowness  of  the  orifice  and,  in  the  elevated 
position  of  the  head,  by  gravitation,  it  frequently  becomes  im- 
prisoned and  inspissated  and  proves  a  permanent  source  of  irrita- 
tion and  discharge.  In  the  early  stages  the  contents  are  glairy 
with  whitish  or  yellowish  clots  ;  later  they  are  creamy,  caseous 
or  even  cretaceous.  The  mucosa,  at  first  red,  congested  and  tume- 
fied, becomes  in  chronic  ca.ses,  hard,  thick,  ptickered  and  adher- 
ent to  adjacent  structures.  It  sometimes  ulcerates  and  the  con- 
tents escape  in  mass,  through  the  pharynx  and  nose,  or  externally 
behind  the  angle  of  the  lower  jaw.  In  the  last  case  water  swal- 
lowed may  escape  through  the  opening.  More  commonly  the 
ptis  remains  pent  up,  and  thickens,  and  may  dry  and  roll  into 
round  or  oval  pellets  from  the  tiiovenients  of  deglutition.     The  dis- 

94 


Col/cdio/is  of  Pus  in  the  Guttural  Pouches.  95 

charge  may  be  arrested  for  weeks  or  months  when  such  masses 
block  the  outlet. 

SyDiptoms.  The  nasal  discharge  is  intermittent  or  irregular, 
being  often  partially  or  wholly  suppressed  by  keeping  the  head 
elevated,  and  reappearing  or  becoming  profuse  when  it  is  lowered. 
Feeding  from  the  ground,  nibbling  roots,  or  pasturing  increases 
the  discharge,  as  the  dependent  position  of  the  outlet,  the  jerk- 
ing and  shaking  of  the  head  and  the  movements  of  deglutition  all 
favor  its  exit.  Swelling  of  the  parotidean  region,  a  flatness  in- 
stead of  resonance  on  percussion,  and  the  flattening  and  dis- 
charge and  sometimes  gurgling  by  manipulation  are  characteris- 
tic. There  is  cough,  roaring  during  active  exertion,  sometimes 
dj'spnoea,  and,  in  bad  cases,  food  may  be  drawn  into  the  bronchia 
with  serious  and  even  fatal  results.  When  the  orifice  is  blocked 
and  the  pouch  filled  with  gas  the  elastic  swelling  and  resilience 
are  characteristic,  and  pressure  may  flatten  it  with  a  gurgling 
sound.  These  symptoms,  serve  to  differentiate  it  from  peripharyn- 
geal abscess.  The  submaxillary  lymphatic  glands  are  usually 
swollen  but  less  than  in  glanders  and  not  so  hard. 

Treatment.  In  mild  and  recent  cases  in  which  the  contents  of 
the  pouch  have  not  yet  become  thick  and  dry,  a  cure  may  be 
effected  ;  in  winter  b)^  feeding  the  animal  from  the  ground  and 
largely  with  roots  ;  a7id  in  summer,  by  turning  out  to  gra.ss.  In 
either  case  the  matter  is  allowed  to  escape  almost  as  soon  as 
formed  and  the  irritated  membrane  tends  to  resume  its  healthy 
functions.  This  result  will  be  favored  by  giving  a  course  of 
tonics  as  recommended  in  simple  ozcciia,  and  the  application  of  a 
mild  blister  to  the  throat. 

Should  this  fail  an  operation  must  be  resorted  to.  Gunther,  of 
Hanover,  uses  an  instrument  in  the  form  of  a  tube  a  yard  long, 
half  an  inch  in  diameter,  slightly  curved  for  two  inches  at  one 
end  which  is  blind,  and  having  an  orifice  on  one  side  close  to  this 
extremity.  This  tube  having  been  introduced  through  the  cham- 
ber of  the  nose  on  the  affected  side  and  its  curved  end  having 
been  carried  into  the  narrow  opening  of  the  Eustachian  pouch, 
tepid  water  is  pumped  in  and  the  pouch  thoroughly  cleaned  out. 
Astringent  solutions  are  then  employed.  The  introduction  of  the 
tube  is,  however,  a  very  difficult  operation  and  one  quite  impossi- 
ble to  any  one  who  has  not  the  most  accurate  knowledge  of  the 
parts  in  question. 


^G  Veterinary  Medicine. 

A  second  mode  of  operating  is  by  external  incision.  For  this 
purpose  are  wanted  scissors,  knife,  artery  forceps,  iron  probe  bent 
in  the  form  of  the  letter  S,  and  a  tape.  The  horse  having  been 
thrown  and  fastened  and  the  head  extended,  the  hair  is  removed 
from  a  surface  in  front  of  the  prominent  border  of  the  first  bone 
of  the  neck,  and  an  incision  made  between  this  border  and  the 
parotid  gland.  The  incision  is  made  immediately  beneath  a 
tendon  which  may  be  felt  as  a  flattened  cord  crossing  the  border 
of  the  bone  in  its  upper  third,  and  it  should  be  carried  downward 
one  and  a  half  inches  parallel  to  the  margin  of  the  bone.  In  this 
preliminary  stage  the  operator  has  to  carefully  avoid  injury  to  the 
parotid  gland  and  the  posterior  auricular  artery  and  vein.  The 
skin  and  fascia  having  been  divided  the  index  finger  of  the  left 
hand  is  pushed  inward  and  forward  until  the  prominent  angle  of 
the  large  cornu  of  the  hyoid  bone  is  felt,  together  with  the 
muscle  (stylo-hyoid)  inserted  into  this  bone  above  the  angle 
referred  to.  The  next  step  is  importajit  since  crossing  on  the 
inner  side  of  this  muscle  and  bone  at  their  point  of  union  is  the 
(internal  carotid)  artery  which  becomes  subsequently  enveloped 
in  a  fold  of  the  membranous  wall  of  the  guttural  pouch.  The 
slightest  variation  in  the  position  of  the  artery  may  here  prove 
fatal  unless  the  greatest  caution  is  used.  With  the  knife  guarded 
by  the  index  finger  of  the  right  hand  the  muscle  is  cut  through 
from  behind  forward  and  the  pulsation  of  the  artery  felt  for  be- 
neath. Avoiding  its  position  the  knife,  with  its  cutting  edge 
turned  forward  and  its  point  directed  toward  the  horse's  nose,  is 
pushed  through  the  walls  of  the  sac.  The  curved  prob  is  now 
introduced  and  carried  downward  until  it  is  felt  beneath  the  skin 
just  behind  the  angle  of  the  lower  jaw.  This  may  be  safely  cut 
down  upon  with  the  knife  as  important  parts  (vessels  and  nerves) 
have  been  turned  aside  by  its  pressure.  A  tape  attached  to  the 
prob  is  now  drawn  through  the  pouch  and  retained  by  a  knot  on 
each  end.  Tepid  water  must  be  injected  through  the  lower  orifice 
daily  for  three  weeks,  astringent  antiseptic  injections  thrown  in 
occasionally  and  the  horse  fed  from  the  ground.  At  the  end  of 
this  period  the  tape  may  be  removed,  and  the  wounds  allowed  to 
heal.  During  the  course  of  treatment  it  is  always  advisable  to 
change  the  tape  several  times  by  cutting  the  knot  off  one  end  of 
the  old  one,  stitching  the  new  one  to  it  and  drawing  it  through. 


Collections  of  Pus  in  the  Guttural  Ponchcs.  97 

Puncture  of  the  pouch  at  its  lozver  part  is  a  very  simple  opera- 
tion when  the  accumulation  of  pus  is  abundant  and  chronic. 
The  distended  pouch  gravitates  downward  largely  separating  the 
parotid  from  the  deeper  vessels  and  nerves,  and  finally  fluctuates 
toward  the  lower  end  of  the  gland.  In  extreme  cases  it  even 
opens  and  discharges.  When  fluctuation  can  be  felt  the  sac  may 
be  incised  with  a  bistuory  or  abscess  knife  and  treated  like  a  com- 
mon sore.  Opening  with  a  pointed  or  olive-shaped  cautery  has 
the  advantage  of  checking  haemorrhage  and  securing  more  per- 
fect drainage.  When  there  is  no  fluctuation  the  incision  must  be 
made  just  beneath  the  lower  border  of  the  parotid,  the  parotido- 
auricularis  being  first  cut  through,  then  the  gland  dissected  from 
the  deeper  parts  when  the  distended  sac  can  usually  be  felt  and 
opened.  If  not  felt  at  once  it  can  easily  be  reached  by  a  careful 
dissection  upward  through  the  loose  subparotidean  connective 
tissue,  with  the  finger  nail  or  handle  of  the  scalpel.  A  free  open- 
ing may  be  made  and  the  wound  injected  daily  with  a  weak 
antiseptic  solution. 

ABSCEvSS   OF   THE   FAI,SE   NOSTRIL. 

In  young  horses  as  the  result  of  injury  from  the  bridle  or 
severe  coryza,  a  circumscribed  swelling  sometimes  appears  on  the 
outer  flap  of  the  nostril,  at  first  firm,  hot  and  tender,  with  a  sur- 
rounding pasty  infiltration,  then  forming  into  a  tense  elastic 
ovoid  mass,  the  size  of  a  pigeon's  or  chicken's  egg.  It  may  be- 
come chronic  and  remain  for  an  indefinite  period  comparatively 
insensible  to  touch  and  only  slightly  interfering  with  the  move- 
ments of  the  nostrils.  As  soon  as  the  elastic  tension  betrays  the 
presence  of  pus  it  should  be  evacuated  by  a  free  incision  made 
from  inside  the  nostrils  and  the  wound  plugged  with  medicated 
tow  and  allowed  to  heal  by  granulation. 


NEOPLASMS  IN  THE  HORSE'S  NOSE. 

Nasal  fibrous  polj'pus,  connection,  form,  size,  bony  distortion,  obstructed 
breathing,  abrasion,  ulceration,  sloughing,  sub-mucous  polypus,  structure, 
degeneration.  Symptoms,  sneezing,  snuffling,  discharge,  palpation,  bony 
swelling,  tenderness.  Treatment,  forceps,  hook,  ecraseur,  knife,  saw. 
Actinomycosis.  Sarcoma,  Carcinoma.  Consistency,  structure,  fcetor, 
glandular  swelling.  Treatment.  Recurrence.  Fatty  tumors.  Bony  tu- 
mors :  cancellated  or  compact  tissue,  localized  or  extended.  Cysts. 
Strougyli.  Angioma.  Varicosity.  Color,  obstruction  to  breathing,  haem- 
orrhage, cicatrization. 

These  are  cssentiall}-  surgical  diseases  yet  as  they  induce 
Chronic  Catarrh  they  may  be  profitably  noticed  here. 

I.  Fibrous  Nasal  Polypus.  These  are  connected  to  the  mu- 
cosa by  a  pedicle  or  broad  base,  and  vary  in  size  from  a  pea  to  a 
mass  which  fills  the  entire  nasal  chamber,  projects  from  the  nos- 
trils and  presses  outward  the  septum  and  facial  bones.  At  times 
they  weigh  one  or  more  pounds.  They  may  cause  whistling  or 
rattling  in  breathing,  or  may  completely  obstruct  the  passage  of 
air  on  the  affected  side.  In  time  they  may  cause  bulging  or  even 
attenuation  and  perforation  of  the  bony  walls,  projecting  through 
the  hard  palate  or  on  the  face.  Sometimes  the  surface  becomes 
the  seat  of  granulation,  ulceration,  or  sloughing,  causing  more  or 
less  foetor.  The  large  polypi  make  their  main  growth  forward 
and  backward,  moulding  themselves  to  the  form  of  the  chamber, 
and  displacing  the  turbinated  bones.  They  commence  to  grow 
under  the  mucous  membrane  and  as  they  grow  and  become  more 
loosely  attached  they  carry  this  as  an  outer  covering  and  pedicle. 
When  incised  they  show  a  structure  of  interlacing  bundles  of  fi- 
bres, with  cell  elements  more  or  less  abundant,  according  to  the 
rapidity  of  growth.  Gravitz  found  amyloid  degeneration  of  the 
walls  of  the  blood  vessels  and  mucous  follicles  and  of  the  fibres. 

Symptoms  are  difficult  breathing,  snuffling,  a  smaller  cur- 
rent of  air  on  the  affected  .side,  or  none,  sneezing,  a  watery,  puru- 
lent, bloody,  or  foetid  discharge,  and  the  appearance  of  the  poly- 
pus when  the  nasal  chamber  is  examined  in  a  good  light.  If  be- 
yond reach  of  vision  the  polypus  may  often  be  felt  by  the  finger. 
Care  must  be  taken  not  to  mistake  the  red,  angry  surface  of  the 
.98 


Neoplas)?is  in  the  Horse's  Nose.  99 

turbinated  bones  in  Catarrh  for  a  polypus.  If  beyond  the  reach 
of  the  finger,  the  flat  sound  on  percussion  of  the  nasal  and  frontal 
bones  on  the  affected  side,  and  the  persistently  diminished  flow 
of  air  may  serve  for  diagnosis.  Tenderness  shown  on  percussion 
is  common  to  this  and  abscess  of  the  sinuses. 

Treatment.  The  horse  having  been  cast  with  the  diseased  side 
uppermost  and  the  head  turned  to  the  light,  the  tumor  is  seized 
with  the  fingers,  the  forceps,  or  hook,  and  drawn  gently  outward. 
The  chain  of  the  ecraseur  may  be  passed  over  it  and  slowly  tight- 
ened upon  the  pedicle  until  it  is  cut  through.  This  will  usually 
obviate  any  laceration  of  the  turbinated  bones  and  consequent 
bleeding.  In  case  of  serious  haemorrhage  check  by  cold  water, 
ice,  the  actual  cautery,  or  by  plugging.  Polypi  with  a  broad  base 
may  be  removed  with  a  prob-pointed  knife,  curved  on  the  flat, 
and  furnished  with  a  long  handle.  The  mass  is  seized  with  a  vul- 
sella and  detachment  made  by  passing  the  knife  with  the  concave 
side  toward  the  tumor.  In  cases  where  the  tumor  cannot  be  seen 
or  reached  some  have  resorted  to  slitting  up  the  outer  wall  of  the 
nostril  as  far  as  the  angle  of  union  of  the  nasal  and  maxillary 
bones,  care  being  taken  to  make  the  incision  outside  the  upper 
end  of  the  cartilage  of  the  ala  nasi.  If  too  high  to  be  satisfactorily 
reached  in  this  way  the  nasal  or  frontal  bone  may  be  trephined 
over  the  body  of  the  tumor  as  indicated  by  the  flatness  on  percus- 
sion, and  the  operation  performed  through  the  opening  thus  made. 

II.  Actinomycosis.  Though  much  more  common  in  cattle 
than  horses,  yet  the  occasional  occurrence  of  this  in  the  face  of 
the  solipede  must  not  pass  unnoticed. 

III.  Sarcoma  and  Carcinoma.  These  are  found  growing 
from  the  periosteum,  or  even  starting  in  the  cancellated  tissue  and 
projecting  into  the  nose,  where  they  give  rise  to  symptoms  like 
those  of  fibrous  polypi.  Being  much  softer  in  texture  and  more 
liable  to  ulceration  and  degeneration  they  are  likely  to  cause  a 
much  more  offensive  discharge.  There  is  also  more  tendency  to 
the  implication  of  the  submaxillary  lymphatic  glands.  The  only 
treatment  is  surgical  and  recurrence  is  always  to  be  feared.  (See 
Disea.ses  of  the  Orbit.) 

IV.  Fatty  Tumors  of  the  nose  are  described  by  Roll  and  Gurlt 
as  existing  on  the  septum  and  in  the  sinuses.  Being  simple,  they 
can  be  removed  with  great  confidence  as  to  nonrecurrence. 


loo  Veterinary  Medicine. 

V.  Osseous  Tumors  of  the  Nasal  walls.  These  are  de- 
scribed by  Roll  as  osteophytes  in  the  maxillary  sinus  in  chronic 
catarrh,  and  by  Gamgeeas  osteomata  attached  to  the  outer  wall 
of  the  nasal  chamber,  which  had  to  be  detached  by  saw  and  bone 
forceps.  I  have  found  these  latter  of  a  soft  porous  structure  easily 
detached  by  the  knife,  and  in  other  cases  dense  and  requiring, 
chisel,  saw  and  forceps.  In  one  instance  the  tumor  grew  from  a 
dense  hypertrophy  of  the  maxillary  bone  which  could  not  be 
entirely  removed  because  the  molar  alveoli  were  implicated. 

VI.  Cysts  named  by  Roll  and  others  as  present  in  the  mucosa 
of  the  ethmoid  cells  in  solipedes  often  contain  larva  of  the 
strongylus  armatus. 

VII.  Angioma  may  be  but  an  exaggerated  development  of  the 
abundant  venous  plexus  and  erectile  tissue  on  the  surface  of  the 
turbinated  bones.  There  appears  to  be  at  other  times  an  actual 
increase  of  the  vascular  tissue.  As  might  be  expected  it  has  no 
abrupt  margin,  but  gradually  shades  off  into  the  healthy  tissue. 
The  prominent  centre  has  a  bluish  red  or  brownish  hue.  It  ob- 
structs breathing,  is  apt  to  bleed  under  violent  exertions  in 
draught,  or  in  contested  races,  and  readily  ulcerates  with  a  bloody 
discharge.  If  it  subsides  and  heals,  it  is  followed  by  a  whitish 
puckering  like  the  so-called  cicatrix  of  glanders. 


CATARRH    OF  THE   FRONTAI.  SINUSES   IN    CATTI.E. 
CATARRH  FROM  TRAUMATISM. 

Extent  of  sinuses  in  cattle.  Causes,  blows,  unequal  teams,  locking  horns, 
fracture.  Pathology.  Congestion,  exudation,  suppuration,  swelling  and 
closure  of  outlet,  prostration,  fever,  agalactia,  septic  infection,  ulceration, 
exclusion  of  oxygen.  Symptoms.  Crimson  haemorrhage,  disturbed  breath- 
ing, appetite,  rumination,  position  of  head  and  eyelids,  percussion  and 
temperature  of  forehead,  fever.  Chronic  form.  Slow  progress,  emaciation, 
anorexia,  facial  expression,  hide,  discharge,  breath  heavy  or  foetid.  Dura- 
tion. Prognosis.  Lesions  in  sinuses  and  glands.  Treatment.  Cold  irriga- 
tion, icebags,  elevation  of  head,  laxatives,  diuretics,  dehorning,  trephining, 
injections,  astringent,  antiseptic,  blister,  tonics. 

The  gravity  of  this  affection  is  a  consequence  of  the  great  ex- 
tent of  the  delicate  mucous  membrane  which  lines  the  frontal 
sinus.  This  cavity  not  only  occupies  the  whole  forehead  from 
beneath  the  eyes  up  to  the  frontal  crest,  but  extends,  in  the  ma- 
ture horned  animal,  into  the  tapering  bony  process  which  forms 
the  basis  of  support  for  the  horn.  The  mucosa  is  rendered  all 
the  more  extensive  by  the  numerous  pillars  and  septa  that  pass 
from  the  outer  bony  plate  to  the  inner,  giving  great  strength  to 
the  part  for  purposes  of  offense  and  defence.  Inflammation  of 
this  membrane  is  usually  the  result  of  blows  on  the  horns,  and 
these  are  much  more  common  among  working  oxen  than  dairy 
cows.  The  immediate  cause  is  violent  contact  with  the  yoke 
when  the  head  is  lowered  at  pasture,  and  from  blows  of  a  club  in 
the  hands  of  the  driver.  In  countries  where  the  yoke  is  a  broad 
padded  board  hung  from  the  horns  and  resting  on  the  forehead 
traumatic  injuries  are  much  more  common.  The  active  and  vig- 
orous animal  gets  the  greater  part  of  the  work,  and  the  wrench 
and  jar  may  induce  haemorrhage  and  catarrh.  If  the  yoke  is  ill- 
made  or  badly  fitted  the  case  is  worse.  The  blows  sustained  by 
horn  or  forehead  in  an  ordinary  fight,  may  also  be  the  cause,  and 
a  partial  or  complete  fracture  of  the  bony  support  is  especially 
hurtful  when  the  detached  horn  is  replaced  so  as  to  close  in  the 
cavity.     Blows  on  the  frontal  crest  are  also  dangerous. 

^\\Q  pathology  of  the  disease  consists  in  an  inflammation  of  the 
mucosa  of  the  sinus,  and  the  filling  of  that  cavity  with  blood  or, 

lOI 


I02  Vcierhiary  Medicine. 

later,  with  a  muco-purulent  fluid,  the  escape  of  which  is  prevented 
by  the  closure  of  the  nasal  outlet  by  swelling.  This  of  itself  pro- 
duces violent  headache  and  much  nervous  disorder  as  witnessed 
by  the  drooping  head,  closed  eyelids,  prostration,  high  fever, 
anorexia,  and  in  cows  suppression  of  the  milk  secretion.  But 
there  is  reason  to  believe  that  this  is  aggravated  by  the  septic 
germs,  which  inspired  with  the  air,  were  already  present  in  the 
sinus,  and  which  in  the  comparative  absence  of  oxygen,  in  a  rich 
culture  medium  and  in  contact  with  injured  and  debilitated  tissues, 
assume  an  enhanced  pathogenic  role.  This  may  serve  to  explain 
the  ulceration  of  the  mucosa  of  the  sinus  found  in  subjects  that 
have  suffered  for  some  time.  It  further  explains  the  notorious 
fact  that  the  free  access  of  air  (oxygen)  to  the  inflamed  sinus  is 
one  of  the  most  helpful  therapeutic  measures. 

Symptoms  of  the  Acute  Form.  When  the  disease  is  traumatic 
the  first  symptom  is  usually  a  haemorrhage  from  the  nose,  the 
blood  being  of  a  bright  crimson.  Respiration  is  hurried,  and  ap- 
petite diminished,  yet  rumination  may  be  imperfectly  performed. 
The  bleeding  may  be  repeated  for  days  in  succession,  but  the  ox 
is  still  capable  of  work.  On  the  fifth  or  sixth  day  there  is  com- 
plete anorexia,  rumination  ceases,  the  head  sinks  resting  on  the 
manger  or  soil,  the  ears  droop  forward  and  downward,  and  may 
be  swollen.  The  head  inclines  to  the  affected  side,  the  corres- 
ponding horn  is  intensely  hot,  and  the  eyes  are  closed.  Light 
percussion  of  the  forehead  on  the  affected  side  gives  pain,  and  the 
sound  elicited  is  flat  and  dull  as  compared  with  that  from  the  op- 
posite side.  The  temperature  of  the  body  rises  2°  or  more,  the 
pulse  becomes  frequent,  full  and  hard  and  the  impulse  of  the 
heart  abnormally  strong.  Costiveness,  partially  suppressed  and 
high  colored  urine,  and  dry  hot  muzzle  betray  the  fever.  Unless 
relieved  the  chronic  form  may  supervene. 

Symptoms  op  the  chronic  form.  When  this  comes  on 
slowly,  working  oxen  get  emaciated,  lose  appetite,  have  the  eyes 
dull  and  sunken,  and  the  lids  drooping,  the  coat  rough  and  star- 
ing and  the  skin  harsh,  dry,  and  lacking  in  pliancy,  the  head  is 
carried  low  when  out  of  the  yoke  and,  after  shaking  the  head  and 
sneezing,  a  glairy,  slightly  foetid  matter  escapes  from  the  nostril. 
The  breath  is  foetid  and  appears  to  be  offensive  to  adjacent  cattle. 

This  may  continue  for  months  with  no  other  change  than  a 


Catarrh  of  the  Frontal  Simiscs  in   Cattle.  103 

more  constant  nasal  discharge,  and  increasing  emaciation  and 
weakness. 

Prognosis.  This  is  favorable  for  the  acute  disease  at  the  outset. 
But  if  no  relief  is  furnished  it  is  liable  to  go  on  to  a  fatal  issue. 
Even  the  chronic  form  is  curable  unless  the  subject  has  alread}' 
become  hopelessh'-  weak  and  debilitated. 

In  fatal  cases  the  sinuses  are  found  to  be  filled  with  a  glairy 
fluid  and  the  mucosa  thickened  and  raw  or  ulcerated.  There 
may  be  enlargment  of  the  pharyngeal  lymphatic  glands,  and  there 
may  be  attendant  pharyngitis. 

Treatment.  The  patient  must  have  absolute  rest  and  cold 
water  irrigation  or  icebags  applied  to  the  head.  The  bowels  may 
be  opened  by  a  saline,  or  a  diuretic  administered.  If  the  head  is 
persistently  dropped  it  may  be  kept  moderately  elevated  by  a 
halter  tied  to  a  higher  point.  Should  there  be  no  relief  at  the  end 
of  twenty-four  hours,  no  time  should  be  lost  in  securing  free  ad- 
mission of  air  to  the  cavity.  Cruzel  advises  to  saw  off  the  horn 
at  its  base,  as  the  one  certain  method  of  securing  prompt  improve- 
ment and  speedy  recovery.  If  a  horn  and  its  bony  support  have 
been  broken  off  the}'  should  be  at  once  removed  and  the  head 
turned  up  to  evacuate  the  accumulated  glairy  fluid  from  the  sinus. 
From  an  apparently  hopeless  condition  a  few  hours  will  suffice  to 
restore  an  appearance  of  good  health.  If  the  horn  has  not  been 
broken  and  it  is  desirable  to  save  it,  the  bone  may  be  trephined 
in  front  of  the  root  of  the  horn  and  the  liquid  evacuated,  or  less 
effectively  and  more  painfully  the  horn  may  be  bored  at  its  root 
by  a  large  gimlet. 

If  no  haemorrhage  has  taken  place  and  if  active  treatment  has 
been  adopted  at  the  outset  recovery  may  be  complete  in  two  or 
three  days,  but  if  the  disease  has  been  ushered  in  by  a  haem- 
orrhage which  recurs  several  days  in  succession,  amputation  of 
the  horn  or  trephining  will  be  demanded.  In  chronic  cases  this 
should  be  followed  by  astringent  and  antiseptic  injections  and  a 
blister  may  be  applied  to  the  throat  or  the  side  of  the  neck.  In 
these  cases  too  a  course  of  mineral  tonics  is  desirable. 


CHRONIC  CATARRH  OF  CATTLE. 

Catarrh,  chronic,  summer  aggravation,  thickened,  roughened,  mucosa, 
discharge,  twigs  in  nose.  Question  of  parasitism.  Treatment,  remove 
causes,  antiseptic  astringents. 

A  remarkable  form  of  chronic  catarrh  with  summer  aggrava- 
tion exists  in  some  of  the  hilly  districts  of  New  York  but  has  not 
received  such  study  as  to   enable  us  to  .state  its  true  nature. 

One  or  two  in  a  large  herd  will  have  a  loud  snuffling  breathing, 
which  ma}^  subside  so  as  to  be  entirely  overlooked  in  winter,  but 
reappears  when  put  to  pasture  in  the  spring  and  continues  in  a 
marked  form  throughout  the  warm  weather  and  until  after  the 
animal  is  returned  to  winter  quarters.  There  appears  to  be  little 
or  no  fever  nor  constitutional  disturbance  except  what  comes  from 
the  obstructed  breathing,  and  the  yield  of  milk  may  be  unchanged. 
The  symptoms  would  indicate  a  purely  local  disease.  Yet  so  few 
are  attacked  out  of  a  herd  that  it  cannot  be  actively  contagious. 

On  close  examination  the  nasal  chambers  are  found  to  be  nar- 
rowed, there  is  manifest  thickening  of  the  mucosa,  and  its  sur- 
face feels  rough  and  uneven,  with  miliarv  elevations.  There  is 
of  course  more  or  less  glairy  discharge.  If  the  examination  is 
made  about  midsummer,  the  finger  introduced  into  the  nose  will 
usually  detect  the  ends  of  twigs  that  have  been  introduced  into 
the  cavity  and  broken  off.  When  withdrawn  these  may  prove 
individually  from  four  to  eight  inches  long,  and  some  force  may 
be  required  to  extract  them.  In  winter  these  are  often  absent, 
having  been  apparently  dropped  one  by  one.  The  absence  of 
these  sources  of  irritation  sufficiently  accounts  for  the  manifest 
improvement  during  the  colder  months.  In  spite  however  of  the 
wdnter  remissions  the  disease  tends  to  a  steady  advance  year 
by  year.  While  nothing  definite  is  known  of  its  pathology,  the 
occurrence  of  this  disease  in  given  localities,  its  manifestly  local 
natttre,  and  its  persistence  wdien  once  established  would  suggest 
enquiry  as  to  the  possible  exi.stence  of  parasitism,  bacteridian  or 
otherwise. 

Until  further  discovery  treatment  can  only  be  of  a  general  na- 
ture. Removal  of  the  foreign  bodies  from  the  no.se,  pasturage 
where  there  is  no  brush  to  replace  them,  soiling  when  clean  pas- 
tures cannot  be  found,  and  the  use  of  astringent  and  antiseptic 
agents  by  insufflation  or  injection  would  be  indicated. 
104 


MALIGNANT  CATARRH  OF  CATTLE. 

Local  causes.  Debilitation.  Polluted  air.  Poor  diet.  vSymptoms,  gas- 
trointestinal, fever,  lacryniation,  turbid  aqueous,  photophobia,  congestion 
of  mucosse,  generally  disturbed  circulation,  breathing,  depression,  heat  of 
forehead,  buccal  petechite,  epithelial  desquamation,  abrasions,  ulcers,  abor- 
tion, albuminuria,  local  swellings,  shedding  of  horns,  dropsy,  dyspnoea. 
Lesions,  in  nasal  mucosa,  subcutem,  cerebral,  dark  blood.  Prognosis. 
Treatment,  antiphlogistic,  laxative,  diuretic,  tonic,  locally  steam,  antisep- 
tic, astringent,  trephining. 

This  disease  occurs  chiefly  in  cold  damp  n.arshy  localities  where 
the  vital  power  is  impaired  or  in  cold  situations  exposed  to  severe 
north  and  east  winds.  In  the  wet  cold  seasons  of  spring  and 
autumn  it  is  especially  prevalent.  According  to  RycJmcrW.  rarely 
attacks  old  cows  but  prevails  among  young  cows  and  oxen.  In 
the  south  of  France  on  the  contrary  it  appears  chiefly  in  the  hot 
season  (June  and  July)  and  is  attributed  to  suppressed  transpira- 
tion. It  prevails  especially  however  in  herds  kept  in  small  filthy 
stables,  low  in  the  roof,  hot,  close  and  badly  aired.  (Festal). 
In  New  York  it  appears  in  cattle  on  black  muck  pastures  and  in 
Minnesota  on  the  dried  up  ponds. 

Symptoms.  Diarrhoea  is  a  common  premonitory  symptom  aris- 
ing from  the  irritation  of  the  intestinal  canal  as  it  is  soon  followed 
by  some  degree  of  costiveness,  the  dung  becoming  dark  colored, 
firm  and  scanty.  Diarrhoea  reappears  later.  The  coat  stares  or 
the  beast  actually  shivers  ;  the  head  is  depressed  ;  the  roots  of 
the  horns  and  the  forehead  are  hot  ;  the  eyes  are  sunken,  swollen 
and  red,  suffused  with  tears,  turbid  in  their  anterior  chamber 
(aqueous  humor)  and  intolerant  of  light  ;  The  muzzle  dry  and 
hot ;  the  mouth  hot  but  moist  with  abundant  saliva ;  the  mucous 
membranes  of  the  mouth,  nose  and  vagina  have  a  bluish  red  color  ; 
the  pulse  is  rapid  and  more  or  less  full  or  hard  ;  impulse  of  the 
heart  weak  ;  the  breathing  is  accelerated,  the  respiratory  sound  is 
heightened  in  intensity  and  a  cough  is  frequent.  Temperature 
104°  to  107°  F.  The  urine  is  scanty  and  high  colored.  The 
surface  of  the  body  is  alternately  hot  and  cold,  and  after  some 
time  a  watery  fluid  begins  to  distil  from  the  nose. 

At  the  end  of  twenty-four  hours  the  symptoms  are  intensified 

105 


io6  Vcteritiary  Medicijie. 

or  altered.  The  eyelids  are  more  swollen  and  the  flow  of  tears 
more  profuse  ;  the  nasal  discharge  becomes  slimy,  and  streaked 
with  blood,  and  accumulations  take  place  in  the  frontal  sinuses  as 
indicated  bj^  the  increasing  heat  of  the  forehead  and  the  dullness 
on  percussion.  In  the  mouth  appear  dark  red  spots,  from  blood 
extrava.sation,  over  which  the  epithelium  sloughs  off  leaving  raw 
unhealthy  .sores.  The  appetite  entirel}^  fails  ;  dung  and  urine  are 
passed  painfully  and  with  effort,  and  abortion  frequently  takes 
place  in  pregnant  cows.  The  urine  is  albuminous  with  cell  forms, 
and  casts.     The  limbs  appear  rigid  and  it  pains  the  animal  to  move. 

From  the  fourth  to  the  .sixth  day  the  ulceration  appears  on  the 
mucous  membrane  of  the  no.se  which  has  often  a  claret  color,  and 
the  nasal  di.scharge  becomes  again  more  watery  and  irritating. 
The  muzzle  is  swollen  and  a  dropsical  infiltration  appears  beneath 
the  jaws  which  extends  along  the  neck  to  beneath  the  thorax  and 
into  the  limbs.  Portions  of  the  nasal  mucous  membrane  now 
.slough  off,  and  similar  sloughs  are  often  seen  on  the  skin  of 
different  parts  of  the  body  ;  the  .secreting  structures  of  the  horns 
and  hoofs  even  participating  so  that  tlie.se  are  ea.sily  detached  or 
.shed.  Saliva  flows  profu-selj-  from  the  lips,  a  fetid  watery 
diarrhoea  succeeds  the  con.stipation,  the  drop.sy  becomes  nearly 
general  and  death  occurs  on  the  eighth,  ninth  or  tenth  day  of  the 
illness.  Convulsions  and  .symptoms  of  suffocation  may  precede 
death. 

In  a  post  mortevi  section  the  principal  lesions  are  found  in  the 
nasal  cavities  and  .skin.  The  areolar  tissue  in  both  is  the  seat  of 
an  abundant  serous  infiltration,  which  has  taken  place  into  the 
deeper  layers  of  the  .skin  as  well,  rendering  it  thick,  hard  and 
unyielding.  Besides  the  sloughs  and  ulcerations  on  the  skin  and 
mucous  membranes,  false  membranes  have  been  met  with,  on  the 
lining  membrane  of  the  mouth  and  air  passages.  The  ulcers  in 
the  no.se  have  in  many  cases  reached  the  bone,  and  from  the 
abundant  infiltration  and  softening,  the  membrane  is  easily 
stripped  from  the  walls  of  this  cavity  and  of  the  sinuses.  The 
general  infiltration  appears  to  have  reached  the  brain,  which  is 
described  as  softened  and  having  an  undue  amount  of  liquid  in 
its  cavities.  The  blood  contained  in  the  vessels  is  dark  colored 
and  numerous  patches  of  extravasation  are  visible  on  the  mucous 
and  .serous  membranes  as  well  as  in  the  interior  of  organs. 


Malii^nant  Catarrh  of  Cattle.  107 

Unless  the  malady  can  be  controlled  in  its  early  stages  it  usually 
proves  fatal.  Patients  that  recover  after  it  has  been  well  devel- 
oped at  times  retain  its  effects  in  permanent  blindness  or  palsy  of 
the  hind  limbs. 

Treatment.  Barly  and  vigorous  antiphlogistic  measures  are 
strongly  recommended  by  French  and  Italian  veterinarians. 
Gelle  and  Ercolani  advocate  the  most  copious  bleedings.  Festal 
insists  that  all  other  measures  are  useless  when  this  is  neglected. 
Before  adopting  free  .sanguineous  depletion  the  history  of  his 
practice  was  a  record  of  deaths,  whereas  later  his  losses  were  in 
cases  where  from  a  failure  to  recognize  the  disease  at  the  outset, 
from  the  exi.stence  of  diarrhoea,  from  the  patient  being  pregnant 
or  from  a  fear  that  the  milking  properties  might  be  impaired, 
bleeding  was  deferred.  He  pushed  the  bleeding  to  the  extent  of 
causing  acceleration  of  pulse,  quickened  breathing  and  heaving 
of  the  flanks,  to  effect  which  sixteen  pounds  had  to  be  abstracted 
on  an  average.  If  this  were  done  early  the  engorgement  of  the 
muzzle  had  usually  greatly  diminished  if  not  entirely  disappeared 
in  the  course  of  seven  or  eight  hours  thereafter.  The  alleged 
benefit  is  probably  largely  due  to  elimination. 

Less  heroic  treatment  is  now  generally  adopted.  An  active 
purgative  (one  and  a  half  pounds  Epsom  salts)  may  be  given 
even  though  apparently  contraindicated  by  the  premonitory 
diarrhoea,  and  a  further  useful  derivation  may  be  obtained  by 
applying  active  friction  or  even  .stimulating  embrocations  to  the 
legs. 

Steam  with  or  without  sulphur  dioxide  may  be  inhaled  as  for 
ordinary  eoryza  and  cold  water  or  ice  kept  applied  to  the  forehead. 

Nitre  in  ounce  do.ses  daily  or  liquor  of  the  acetate  of  ammonia 
in  three  ounce  doses  may  be  given  after  the  purging  has  ceased. 
Or  drachm  do.ses  of  hydrochloric  acid  with  bitters  may  be  given 
thrice  a  day  in  at  least  a  pint  of  water. 

Where  the  na.sal  discharge  persists  after  the  .subsidence  of  the 
other  .symptoms  the  sinu.se  should  be  trephined  in  front  of  the 
horn,  and  tepid  water  and  mild  a.stringent  and  antiseptic  lotions 
injected  until  a  healthy  action  has  been  established.  Change  to 
a  dry,  well  drained  pasture  or  building  is  desirable  for  both  treat- 
ment and  prevention. 

CONTAGIOUS    DISEASES   OF  THE   NOSE. 

The.se  are  omitted  here  to  be  treated  under  that  heading. 


PARASITIC  DISEASES  OF  THE  NOSE. 

Among  these  may  be  named  : 

LEECH   BITES. 

Form  of  wound,  leeches  in  posterior  nares,  discharge  of  blood,  mucus, 
sneezing,  snorting,  dysphagia,  anorexia,  unthriftiness,  ansemia.  Treat- 
ment, removal,  sodium  chloride,  tar  fumes,  ether  on  sponge. 

Though  it  more  commonly  attacks  the  mouth  and  hps  yet  the 
leech  (Hirudo  Decora)  will  sometimes  fasten  itself  inside  the 
nose  when  that  is  plunged  in  water.  Its  bite  is  to  be  recognized 
by  its  triangular  shape.  When  taken  in  by  the  mouth  it  may 
fasten  itself  in  the  posterior  nares  where  it  is  difflcult  to  recognize 
its  presence.  In  the  anterior  nares  it  can  be  readily  discovered 
and  removed,  but  in  the  posterior  nares  it  may  maintain  its  hold 
indefinitely.  There  appear  in  the  nasal  discharge  streaks  or  clots 
of  blood  which  may  also  show  at  the  corners  of  the  mouth. 
Sneezing,  snorting,  and  difficulty  of  deglutition,  may  draw  atten- 
tion to  the  trouble,  and  in  protracted  cases  signs  of  anaemia,  in- 
appetence,  unthriftiness  and  general  weakness.  The  most 
effective  treatment  is  to  remove  the  leech  with  the  fingers,  but  as 
they  cannot  always  be  reached  in  this  way,  an  injection  of  a 
strong  solution  of  common  salt  may  be  used.  Blaise  succeeded 
by  burning  tar  under  the  nose  twice  a  day,  and  Louvigny  by  in- 
troducing a  staff  bearing  a  sponge  soaked  in  ether. 


COCCIDIAN  CATARRH  IN  RABBITS. 

Coccidia  in  rabbit's  nose,  etc.,  inflammation,  fatality.      Treatment,  sul- 
phur dioxide. 

Zurn  describes  a  contagious  catarrh  of  rabbits  caused  by  the 
presence  in  the  mucosa  of  the  nose,  pharynx,  Eustachian  tubes 
and  middle  ears. of  myriads  of  coccidia.  They  create  acute  irrita- 
tion and  prove  fatal  in  many  cases.  Embedded  in  the  mucosa 
they  are  difficult  to  reach  with  medicinal  agents,  yet  the  free  para- 
sites may  be  destroyed  by  frequent  fumigations  with  sulphtirous 
acid,  or  by  spraying  or  injecting  the  nose  with  its  solution. 
1 08 


IvARVA  OF  CEvSTRUS  OVIS  (GRUB)  IN  THE  NASAL 
SINUSES  OF  SHEEP. 

Season  of  attack  by  fly,  bibernation,  botfly  of  sheep,  mode  of  attack, 
embryo,  defensive  acts  of  sheep,  habitat  of  larva,  mature  larva,  its  exit, 
chrysalis  in  soil,  its  transformation.  Symptoms,  sneezing,  snuffling,  rub- 
bing of  nose,  lachrymation,  unsteadiness,  discharge,  respiratory  digestive 
and  febrile  disturbances,  emaciation,  septic  action.  Lesions,  larva,  conges- 
tions of  mucosa,  brain.  Treatment,  warmth,  errhiue,  parasiticides,  mechan- 
ical extractors,  trephining,  injections.  Prevention,  newly  turned  furrow, 
quicklime,  tar.     Other  larva  in  nose. 

Sheep  are  especially  subject  to  the  attacks,  in  summer  and 
autumn  and  in  warm  sunny  barns  even  in  winter,  of  the  CEstrus 
(Cephalemia)  Ovis,  the  larva  of  which  hibernates  in  the  na.sal 
sinuses  or  ttirbinated  bones. 

The  sheep-bot-fly  is  only  about  four  lines  in  length,  of  a  light 
yellowish  or  slightly  brownish  gray  hue,  hairy,  with  dull  black 
transverse  lines  on  the  upper  surface  of  the  thorax,  and  a  lighter 
color  on  the  abdomen  where  the  black  lines  are  more  broken. 
The  transparent,  colorless  wings  extend  beyond  the  bod}-  :  wing- 
lets  are  long  and  cover  the  poisers  :  abdomen  is  formed  of  five 
rings. 

They  appear  during  the  whole  summer  hiding  away  in  walls, 
stumps  and  grass,  unless  when  pairing  or  pursuing  the  sheep  to 
deposit  their  young.  The  mode  of  attack  is  difficult  to  follow  on 
account  of  the  small  size,  gray  color  and  rapid  flight  of  the  fly  and 
fear  and  .shyness  of  the  sheep.  It  cannot  be  doubted,  however, 
that  they  approach  and  drop  on  the  margin  of  the  nostril,  the 
larva  previously  hatched  from  the  egg.  The  old  authors  describe 
the  deposition  of  the  egg  on  the  margin  of  the  nostril  and  its 
prompt  hatching  by  the  animal  heat,  but  the  observations  of 
Brown,  Kelly,  Cockrill,  Riley  aud  Ormerod  abundantly  prove 
that  the  fly  is  viviparous.  Cockrill  obtained  no  less  than  300  live 
hatched  larvae  from  one  fly  caught  while  pursuing  a  sheep. 

The  sheep  seek  to  avoid  the  fly  by  resorting  to  dry  dusty  roads 
where  they  lie  with  the  nose  clo.se  to  the  ground,  or  they  .stand 
with  the  nose  close  to  the  soil  and  between  their  fore  legs.     At 
109 


no  Veterinary  Medicine. 

other  times  they  will  collect  in  a  dense  phalanx  with  their  heads 
directed  toward  the  centre  of  the  mass  and  held  low  so  that  the 
fly  cannot  reach  them.  The  moment  the  fly  touches  the  nose  they 
shake  the  head,  stamp  with  the  feet,  and  gallop  off  with  the  nose 
close  to  the  ground,  looking  from  side  to  side  to  see  if  the  fly  pur- 
sues and  frequently  smelling  at  the  grass  as  if  apprehensive  of 
other  flies  hidden  there.  If  such  appear  they  instantly  turn  and 
scamper  to  other  parts  of  the  field  or  take  refuge  in  a  dry  dusty 
place  or  gravel  bank. 

The  young  larva  when  deposited  on  the  nostril  speedily  makes 
its  way  up  and  takes  refuge  in  the  cavities  of  the  turbinated  bones 
and  the  frontal  and  maxillary  sinuses,  where  it  passes  the  winter 
feeding  on  the  mucus  and  the  purulent  discharges  determined  b}' 
its  presence.  When  mature  it  leaves  the  nose  and  assumes  the 
chrysalis  form  in  the  soil. 

The  mature  larva  is  narrow  anteriorly,  broad  behind  :  its 
upper  surface  is  prominent  and  rounded,  lower  surface  fiat,  and 
furnished  at  the  anterior  of  each  ring  after  the  third,  with  a  series  of 
pointed  tubercles  or  spines  :  the  cephalic  end  bears  the  buccal  or- 
gans directed  downward,  and  bearing  two  great  hooks  connected 
with  the  hard  framework  of  the  pharynx  and  recurved  downward, 
backward  and  outward  ;  mouth  small  ;  antennae  thick  and  short 
placed  above  the  buccal  organs  :  the  inferior  part  of  the  last  ring 
projects  beyond  the  upper  portion  and  is  furnished  with  two 
nodules  with  intervening  spines  :  pentagonal  patches  of  stigmata 
on  the  last  ring  :  very  small  anterior  stigmata  between  the  first 
and  second  rings.  The  color  is  white  with  brown  spines,  stig- 
mata and  transverse  striae.     Length  seven  lines  to  one  inch. 

When  dropped  from  the  nostril  in  the  course  of  summer  they 
pass  into  chrysalis  in  one  or  two  days  ;  and  after  a  residence  of  six 
or  eight  weeks  in  the  soil  emerge  as  the  perfect  fly. 

Morbid  Symptoms  Caused  by  the  Larvae  in  the  Head. 
Grub  in  the  Head.  These  bear  a  close  relation  to  the  number 
of  larvae  present.  If  there  are  only  two  or  three  no  trouble  may 
result.  If  many  there  is  muco-purulent  discharge  from  the  nose, 
sniffling  breathing,  frequent  sneezing  and  snorting  expelling  mu- 
cus and  even  blood  ;  shaking  of  the  head  ;  rubbing  of  the  nose 
on  the  fore  legs  or  other  objects  ;  weeping  eyes  ;  and  occasional 
unsteadiness  of  the  gait. 


Larva  of  CEstrus  Oris  in  the  Nasal  Sinuses  of  Sheep.       1 1 1 

In  the  worst  cases  the  respiration  becomes  sighing,  wheezing  or 
even  snoring  ;  the  mouth  open  ;  head  pendent  ;  appetite  fails  ; 
a  dull,  apathetic  condition  ensues  with  grinding  of  the  teeth  roll- 
ing of  the  eyes,  and,  rapidly  advancing  emaciation. 

Fatal  cases  are  not  uncommon  but  most  frequently  the  larvae 
reaching  maturity  are  dropped  and  health  is  promptly  re-estab- 
lished. Septic  poisoning  from  decomposition  of  dead  larvae  and 
debris  is  a  dangerous  complication. 

Lesions.  These  consist  in  the  presence  of  the  larvae  in  the 
sinuses,  with  violently  congested,  purple  ulcerated  mucous  mem- 
branes and  collections  of  pus.  The  mere  presence  of  the  grub 
is  not  conclusive  as  the  majority  of  the  sheep  harbor  two  or  three 
from  October  to  June. 

Treatment.  It  is  advised  to  place  the  sheep  in  a  warm  building 
to  encourage  the  parasites  to  come  out  of  their  recesses  and  then 
introduce  some  agent  to  destroy  them  or  to  induce  their  expul- 
sion by  sneezing.  The  value  of  the  hot  building  is  probably 
hypothetical  unless  the  larvae  are  approaching  maturity.  The 
following  agents  are  used  : — moderately  strong  solutions  of  salt, 
vinegar,  carbolic  acid,  creo.sote  (i  part  to  loo  parts  of  water),  or 
carbonate  of  ammonia,  lime  water,  snuff,  or  even  such  irritants  as 
quick  lime,  oil  of  turpentine  or  hellebore.  These  last  must  be 
used  with  caution  as  they  are  liable  to  induce  fatal  inflammation 
of  the  air  passages  though  no  larva  is  present. 

By  passing  a  feather  up  the  nostril  twisting  it  round  and  then 
\Vithdrawing  it  some  grubs  can  usually  be  withdrawn  and  there 
is  no  harm  in  first  dipping  the  feather  in  some  of  the  milder 
agents  mentioned  above.  But  the  larvae  in  the  sinuses  can  never 
be  reached  in  this  way. 

In  dangerous  cases  it  is  best  to  trephine  the  outer  plate  of  bone 
covering  the  frontal  sinuse  and  wash  out  freely  with  tepid  water, 
lime  water,  or  benzine.  The  operation  may  be  performed  close 
in  front  of  the  root  of  the  horn  if  there  is  one,  or  to  the  inner  side 
of  the  lower  part  of  the  eye  if  there  is  not.  A  semi-circular  flap 
of  skin  is  to  be  turned  upward  and  backward  sufficiently  large 
to  allow  the  use  of  a  trephine  \  inch  in  diameter,  which  is  to  be 
used  as  for  Qcnurus  Cerebralis.  The  opening  being  made  the 
sinuse  is  to  be  syringed  freely  for  some  time  until  the  parasites 


I  r  2  Veterinary  Medicine. 

come  from  the  nose  in  the  stream  of  Hquid.  The  wound  heals 
very  prompth'.     In  the  absence  of  a  trephine  use  a  gimlet. 

Prevention.  Some  turn  up  a  furrow  in  the  pasturage,  in  which 
the  sheep  may  burrow  their  noses  and  evade  the  fly,  others  lay 
down  quicklime  in  covered  boxes  which  has  the  further  advant- 
age of  inducing  sneezing  and  favoring  expulsion  of  the  entering 
parasites.  But  perhaps  the  best  plan  is  to  procure  a  log  and  bore 
a  number  of  holes  in  it  with  a  two  inch  augnr  ;  place  salt  in  the 
holes  and  smear  their  margins  with  tar,  and  renew  it  often.  The 
sheep  then  takes  a  protective  dressing  with  every  lick  of  salt. 

CEstrus  Purpureus  (Brauer)  is  a  species  which  infest  the  nose, 
etc.,  of  the  Syrian  sheep,  and  Cephalemia  Maculata  (Wedl) 
one  which  infests  the  nasal  chambers  of  the  Egyptian  buffalo  and 
camel. 


NASAIv  CATARRH  IN    DOG   AND    HORSE    FROM    LIN- 

GUATAIvA  (PENTASTOMA)    TAENIOIDES. 

RHINARIA  TAENIOIDES. 

Form.  Family.  Habitat  when  mature,  and  immature.  Development. 
Symptoms,  sneezing,  discharge,  irritability,  ill-temper,  shaking  the  head, 
rubbing  nose,  parasites  in  discharge.  Treatment,  injections,  trephining. 
Prevention. 

This  parasite  has  a  worm-like  body,  but  is  closely  allied  to  the 
mites  and  belongs  to  the  Arachnida.  It  differs  from  the  mite  in 
having  but  four  short  limbs  retractile  and  protractile  and  fur- 
nished with  sharp  claws.  The  body  is  thickest  toward  the  ante- 
rior end  and  prolonged  and  narrow  posteriori}^ ;  marked  by  about 
90  rings  ;  head  rounded  off  abruptly,  mouth  broadly  open,  with 
a  horny  lip  ;  integument  with  numerous  openings  or  stigmata 
(respiratory)  ;  male  7  lines  long  by  a  line  broad  in  its  anterior 
part  genital  orifice  on  the  front  part  of  the  abdomen  in  the  median 
line  ;  female  3  to  4  inches  long,  by  3  or  4  lines  broad  anteriorly  ; 
genital  opening  at  the  end  of  the  tail.     Reprodiictio7i  oviparous. 

Habitat.  Nasal  chambers  and  sinuses  of  the  dog,  wolf,  goat, 
and  horse. 

Pentastoma  De7iticulata.  The  young  partially  developed  P. 
Taenioides.  Has  all  the  rings  except  the  two  first,  garnished  with 
fine  sharp  recurved  spines  ;  legs  more  slender  with  accessory 
booklets  ;  length  2  lines  ;  breadth  \  line. 

Habitat.  Cysts  in  the  lungs,  liver,  mesenteric  glands,  etc. ,  of 
the  hare,  porpoise,  goat,  sheep  and  other  mammals,  not  excepting 
man. 

Development.  Eeuckart  found  that  the  adult  Pentastomata 
copulate  in  the  nasal  chambers,  as  many  as  half  a  million  of  eggs 
being  fertilized  in  a  single  female  ;  that  these  eggs  are  discharged 
with  the  nasal  mucus  and  falling  on  vegetables  are  taken  in  by 
herbivora  ;  their  shells  are  digested  and  destroyed  in  the  stomach, 
and  the  liberated  embryos  perforate  the  intestinal  walls  and  en- 
cyst themselves  in  various  organs.  The  encysted  embryo  varies 
from  -lo  to  -^  inch  in  length,  is  rounded  and  blunt  anteriorly  but 
very  thin  posteriorly  with  the  tail  slightly  curved  toward  the  ven- 
tral aspect.  It  is  several  months  before  the  feet,  cutaneous  spine 
and  generative  organs  are  developed,  and  during  this  period  it 
8  113 


114  Vetermary  Medicine. 

undergoes  several  moultings.  Finall}-  it  leaves  its  cj'st  and  ma\' 
live  free  in  the  cavities  in  the  body  of  its  host,  and  if  it  does  not 
escape  from  the  body  it  finally  constructs  a  new  cyst  and  then 
dies.  If  the  host  is  eaten  by  a  carnivorous  animal  the  liberated 
pentastomata  reach  the  nose  either  from  the  lips  or  pharynx  and 
in  a  few  months  more  acquire  their  complete  development.  They 
must  reach  the  nose  of  the  horse  by  their  presence  in  the  food  or 
water. 

Symptoms  Caused  by  the  Pentastoma.  No  morbid  symptoms 
have  been  traced  to  the  young  encysted  condition  of  the  parasite. 
Yet  it  would  not  be  surprising  if  their  presence  in  large  numbers 
in  the  mesentric  glands  and  liver  should  give  rise  to  troubles  of 
assimilation,  sanguification,  biliary  secretion  and  the  like.  Fre- 
richs  says  they  are  more  common  in  the  human  liver  in  Germany 
than  echinococcus,  but  adds  that  they  have  no  clinical  importance. 

In  their  mature  condition  however  they  cause  considerable  irri- 
tation and  nasal  discharge  when  present  in  large  numbers.  In 
dogs  there  is  running  from  the  nose  the  discharge  containing  an 
abundance  of  the  ova,  restless,  fretful  habits,  sometimes  a  mor- 
bid readiness  to  bite,  frequent  shaking  of  the  head  and  rubbing 
of  the  face. 

The  treatmetit  would  be  to  trephine  the  sinuses  and  inject  lo- 
tions impregnated  with  creosote,  carbolic  acid  or  naphtha.  From 
the  danger  to  man  of  becoming  infested  it  is  important  to  ascer- 
tain the  true  nature  of  any  nasal  discharge  of  the  dog  especially 
in  countries  like  Germany  and  Egypt  in  which  this  parasite  is 
common. 

Prevention .  Deny  raw  offal  of  herbivora  to  dogs. 


AFFECTIONS  OF  THE  THROAT. 

Sore  throat,  Angina,  Cynanche — is  a  generic  name  applied  to  a 
series  of  inflammatory  affections  of  the  various  structures  about 
the  throat.  If  the  larynx  is  specially  inflamed  the  disease  is 
known  2i's,  laryngitis,  if  \\\^  phary7ix ,  as  pharyngitis,  if  there  are 
exudations  forming  false  membranes  it  is  croupous  or  diphtheritic, 
or  if  associated  with  some  general  febrile  affection,  it  takes  its 
name  accordingl}-,  influenza,  strangles,  distemper,  or  scarlatina, 
as  the  case  may  be. 


I.ARYNGITIS  IN  THE  HORSE. 

ANGINA    LARYNGITIS,    CYNANCHE    LARYNGEA,  ETC. 

Causes,  mechanical,  cold,  irritants,  extension,  diet,  close  stables,  infec- 
tious disease.  Symptoms  of  acute  form,  head  extended,  throat  swollen, 
tender  larynx,  cough,  in  early  stage,  after  exudation,  wheezing  in  inspira- 
tion, dysphagia,  fever,  oedena  glottidis,  spasms,  dyspnoea,  successive  dis- 
charges. Lesions,  tumefaction,  softening,  friability,  redness  (ramified  or 
not),  erosions  of  mucosa,  oedema.  Course,  duration,  sequelae,  cough, 
roaring.  Subacute  form,  chronic  form,  in  old  debilitated  animals,  in  those 
reined  too  tightly,  in  those  which  perspire  with  difficulty  or  bear  heavy 
coats.  Symptoms,  local,  in  breathing,  cough,  effect  of  cold  air,  or  water  or 
of  dust.  Sequelae,  ossified  cartilages,  roaring,  emphysema,  bronchiectasis. 
Treatment,  hygienic,  soothing,  sheepskin,  compress,  poultice,  mustard, 
sulphur  dioxide,  laxative,  neutral  salts,  expectorant,  sedative,  derivative, 
tracheotomy,  vpith  trochar  and  cannula,  with  scalpel,  tracheotomy  tubes. 
Insufflation,  injection.  In  chronic  laryngitis,  electuaries,  mustard,  deriva- 
tives, astringents,  caustics,  tonic  inhalations. 

Causes.  These  are  the  ordinary  causes  of  chest  diseases.  As 
special  causes  may  be  noted  severe  compression  of  the  larynx  as 
in  roughly  and  repeatedly  coughing  an  animal ;  the  sudden  con- 
tact of  piercing  cold  air,  of  irritant  gases,  powders  or  liquids 
with  the  membrane,  and  the  rapid,  forcible  and  continuous  cur- 
rent of  condensed  air  through  the  glottis  during  severe  exertion. 

Among  the  general  causes  the  most  fruitful  are  the  high  feed- 
ing, hot,  close  stables,  heats  and  chills,  and  other  circumstances 
attendant  on  domestication.  L,aryngitis  may  be  an  extension 
from  coryza,  pharyngitis,  bronchitis  or  pneumonia.  It  may 
further  be  but  a  local  manifestation  of  influenza  or  strangles, 
contagious  pneumonia,  etc.  The  disease  is  acute,  sicbacute,  or 
chronic. 

Symptoms  of  acute  fonn.  All  acquainted  with  horses  can 
recognize  the  general  symptoms  of  sore  throat.  The  nose  is 
elevated  and  protruded  to  avoid  compression  of  the  larynx  ;  it  is 
carried  stif9.y  for  the  sama  reason.  There  is  some  swelling  around 
the  throat  or  beneath  the  root  of  the  ears.  If  the  cartilages  of 
the  larynx  are  compressed  between  the  finger  and  thumb,  or  if 
pressure  is  made  in  the  median  line  below  upon  the  connecting 
115 


Ii6  Veterinary  Medicine. 

crico-thyroid  membrane  the  patient  instantly  coughs  and  throws 
up  the  head  to  avoid  a  repetition  of  the  suffering.  This  tender- 
ness of  the  larynx  to  touch  is  peculiar  to  laryngitis  and  serves  to 
distinguish  it  from  pharyngitis.  The  cough  is  at  first  very  hard 
and  painful  and  only  gives  way  to  a  soft  mucous  type  when  a  free 
mucous  exudation  puts  an  end  to  the  tense,  thickened  and  dry 
state  of  the  mucous  membrane.  The  inspiratory  act  is  accom- 
panied by  a  whistling  or  deep  bass  sound,  particularly  after  the 
slightest  exertion.  This  may  be  heard  at  times  during  expiration 
as  well,  though  not  invariably  so.  Sometimes  the  animal  drops 
the  food  from  his  mouth  after  mastication,  because  of  the  pain 
attendant  on  swallowing,  but  this  is  really  a  symptom  of  coexist- 
ing pharyngitis,  and  its  absence  implies  the  nonexistence  of  that 
complication.  There  is  usually  a  slight  pasty  swelling  between 
the  branches  of  the  lower  jaw. 

There  are  besides  the  general  symptoms  of  fever  more  or  less 
marked,  such  as  increased  temperature,  accelerated  pulse,  red  in- 
jected eyes  and  nose,  slightly  hastened  breathing,  the  expiration 
being  effected  by  a  double  lifting  of  the  flank  as  in  broken  wind, 
etc. 

In  two  or  three  days  in  favorable  cases  exudation  takes  place 
from  the  mucous  membrane,  the  cough  becomes  softer  and  less 
frequent,  the  local  tenderness  decreases  and  the  general  symptoms 
subside. 

If  otherwise  the  symptoms  may  become  more  intense,  and 
breathing  may  get  loud  and  difficult  in  connection  with  thicken- 
ing and  rigidity  of  the  mucous  membrane,  or  a  serous  exudation 
into  it  and  beneath  it  (oedema  glottidis)  which  by  closing  the 
glottis  renders  breathing  almost  impossible.  The  same  distress- 
ing symptoms  may  arise  from  spasm  of  the  larynx  excited  by  the 
inflammatory  action.  As  arising  from  thickening  or  infiltration 
of  the  membrane  these  symptoms  may  come  on  comparatively 
slowly,  but  in  the  case  of  spasm  they  appear  suddenly  and  have 
periods  of  intermission,  reappearing  •  on  succeeding  days  and 
usually  at  the  earlier  part  of  the  night.  In  such  circumstances 
the  loud,  noisy  breathing  is  heard  at  a  considerable  distance,  the 
horse  stands  obstinately  .still,  the  fore  feet  apart,  his  elbows  turned 
out  to  allow  a  firm  action  of  the  chest,  the  flanks  working 
laboriously,  the  head  low,  the  nose  protruded,  the  nostrils  widely 


Laryngitis  in  the  Horse.  117 

dilated,  the  mouth  open,  the  eyes  standing  out  from  their  sockets 
red  and  wild  looking,  and  the  face  constrained  and  pinched,  the 
whole  expression  being  that  of  intense  agony  from  impending 
suffocation. 

Lesions.  In  cases  where  death  has  supervened,  perhaps  in 
connection  with  another  disease,  the  laryngeal  mucosa,  especially 
on  and  above  the  glottis,  is  soft,  tumid,  friable,  with  ramified  or 
uniform  redness  and  petechial  spots.  The  epithelial  layer  may 
be  softened,  disintegrated  and  shed,  leaving  pointed  or  larger 
erosions,  which  are,  however,  usually  superficial.  In  case  of 
oedema  glottidis  the  mucosa  and  submucosa  are  thickened  by  an 
abundant  exudate  which  may  extend  to  the  connective  tissue  out- 
side the  larynx  as  well.  In  aggravated  cases  there  may  be  dark 
red  or  brownish  red  discolorations  of  the  mucosa. 

Course,  Duration.  Fortunately  these  aggravated  forms  of  the 
disease  are  rare  and  unless  the  patient  perishes  during  such  an 
attack  or  the  inflammation  extends  down  toward  the  chest, 
laryngitis  rarely  proves  fatal.  Its  duration  is  from  twelve  to 
fifteen  days.  Its  extension  to  the  lungs  may  be  suspected  when 
the  extreme  tenderness  of  the  throat  subsides  without  any  corres- 
ponding improvement  in  the  health.  Examination  of  the  chest 
will  then  rarely  fail  to  detect  the  presence  of  disease. 

But  although  sore  throat  is  rarely  fatal  its  effects  are  not  unim- 
portant nor  trivial.  It  occasionally  merges  into  a  chronic  form, 
with  a  hacking  cough,  tenderness  to  pressure  and  an  increased 
liability  to  other  diseases  of  the  air  passages.  More  frequently 
it  is  followed  by  wasting  and  fatty  degeneration  of  the  larj^ngeal 
mu.scles  and  the  horse  becomes  a  confirmed  roarer.  In  all  cases 
it  leaves  a  greater  susceptibility  to  a  second  attack. 

Sub-acute  Laryngitis.  This  form  has  been  chiefly  seen  in 
young  animals  and  up  to  eight  years  old.  At  the  outset  its  symp- 
toms are  moderate  but  as  it  is  usually  associated  with  serous  effu- 
sions in  and  around  the  mucous  membrane  the  symptoms  above 
mentioned  as  indicating  imminent  danger  of  suffocation  may  sudden- 
ly appear  and  life  can  only  be  preserved  by  opening  the  trachea. 

Chronic  Laryngitis.  This  maj^  follow  the  acute  form  or  it 
may  come  on  independently  and  by  slow  degrees.  It  may  ac- 
company nasal  catarrh,  or  chronic  bronchitis.  Old  animals 
which  have  had  heavy  draught  work  and  repeated  attacks  of  sore 


Ii8  Veterinary  Medicine. 

throat,  are  frequent  subjects  of  it,  and  as  Fergusson  has 
pointed  out  it  is  most  prevalent  among  horses  whose  throats  have 
been  compressed  by  the  inconsiderate  use  of  the  bearing  rein. 
Reynal  has  observed  it  often  in  horses  that  are  sweated  with  diffi- 
culty, and  in  those  which  remain  long  wet  from  the  length  and 
thickness  of  their  winter  coats. 

Symptoms.  When  acute  laryngitis  passes  into  the  chronic  form 
all  the  symptoms  subside  except  a  slight  nasal  discharge,  the 
cough,  tenderness  of  the  larnyx,  and  roaring.  The  cough  is 
dry,  short,  and  hacking,  rarely  soft,  and  is  heard  mainly  when 
the  animal  feeds,  when  he  leaves  the  hot  stable  for  the  cold  air, 
and  after  drinking  cold  water.  During  exercise,  it  is  equally  ex- 
cited, the  cough  becoming  harder,  and  the  horse  extending  his 
head  and  neck  as  if  to  disengage  some  body  from  its  throat.  The 
subject  may  in  nearly  all  other  respects  maintain  the  appearance 
of  vigorous  health. 

CoTirse,  etc.  This  disease  is  liable  to  prove  obstinate  and  if  of 
old  standing,  often  incurable.  Unless  checked,  the  continued  con- 
gestion and  irritation  of  the  larynx,  the  frequent,  hacking  cough, 
and  the  consequent  violent  distension  of  the  lungs  bring  about  ex- 
tensive and  irreparable  structural  changes.  Among  these  may 
be  mentioned  ossification  of  the  cartilages  of  the  larnyx  ;  paraly- 
sis of  the  left  laryngeal  nerve  with  wasting  of  the  muscles  to  which 
it  is  distributed,  and  roari^ig  ;  dilatation  of  the  bronchial  tubes, 
and  permanent  distension  and  rupture  of  the  air  cells  (emphyse- 
ma, broken  wind,  heaves). 

Treatment.  Aatte  form.  Unless  in  the  very  mildest  cases  un- 
accompanied by  fever,  repose  is  essential.  If  available,  a  roomy, 
clean,  dry,  and  airy  loose  box  should  be  allowed,  care  being  taken 
to  avoid  draughts  of  cold  air  and  to  secure  a  soft  equable  temper- 
ature neither  too  hot  nor  too  cold.  Blankets  should  be  used  and 
even  flannel  bandages  applied  loo.sely  to  the  legs  if  the  weather  is 
cold,  or,  if  there  is  any  tendency  to  chills  and  shivering.  The 
nostrils  must  be  steamed  as  directed  iox  coryza.  A  piece  of  sheep- 
skin with  the  wool  turned  in  may  be  tied  around  the  throat  and 
up  to  the  ears.  In  very  acute  cases  a  linseed  meal  poultice  or 
wet  pack  may  be  applied  to  the  throat,  while  in  the  milder  forms, 
a  mustard  poultice  or  a  lotion  of  Spanish  flies  or  other  stimulant 
may  be  employed.     Unless  the  malady  has  an  epizootic  type,  with 


Laryngitis  in  the  Horse.  irg 

prostration  and  a  weak,  rapid  pulse,  the  bowels  may  be  opened 
by  a  laxative  (3  or  4  drachms,  aloes),  and  the  water  or  gruel  the 
animal  daily  drinks  should  contain  j4  to  1  ounce  nitre.  As  an 
expectorant  the  patient  may  take  salammoniac  i  oz.  daily  in  the 
drinking  water,  or  this  agent  may  be  evaporated  from  a  clean 
chafing  dish  every  two  hours  and  inhaled.  Or  he  may  take  car- 
bonate of  potash  or  soda,  or  iodide  of  potassium.  If  the  cough  is 
troublesome,  half  a  drachm  of  Dover's  powder  may  be  given  thrice 
a  day  or  i  grain  chloride  of  apomorphine  ever}'-  hour.  Bromide 
of  potassium  or  sodium  may  also  be  resorted  to.  Inhalations  or 
spray  of  sulphurous  acid,  or  vapor  of  oil  of  turpentine  and  insuf- 
flations of  calomel  may  benefit  as  local  applications.  The  diet 
must  be  confined  to  sloppy  bran  mashes,  cut  roots,  or  boiled  bar- 
ley, or  oats.  Hay  should  be  withheld  in  the  more  acute  cases  un- 
til improvement  appears.  Under  treatment  such  as  the  above  and 
even  without  the  medicinal  part  of  it,  the  great  majority  of  cases 
will  do  well. 

In  cases  attended  with  high  fever  with  strong  full  pulse  and 
bright  red  nasal  membrane,  the  purgatives  and  diuretics  are  espec- 
ially called  for,  and  the  former  should  have  their  action  encour- 
aged by  frequent  hot  water  injections.  Twenty  drop  doses  of  the 
tincture  of  aconite  repeated  four  times  a  day,  or  ten  drops  every 
three  hours,  will  be  further  useful. 

When  the  symptoms  are  of  such  a  type  as  portend  the  access  of 
paroxysms  of  threatened  suffocation,  bleeding  has  been  strongly 
recommended,  but  unless  resorted  to  in  the  first  twenty-four  or 
forty-eight  hours  is  rarely  admissible.  Also  in  weakened  constitu- 
tions and  when  the  fever  is  of  a  low  type,  with  small,  weak  pulse 
and  general  dullness  and  prostration,  the  temporary  relief  obtain- 
able from  blood-letting  will  not  often  counterbalance  the  danger  of 
increasing  weakness,  and  the  loss  of  recuperative  power.  In  all 
such  cases  the  application  of  a  strong  mustard  poultice  for  several 
hours  in  succession,  until  an  abundant  effusion  has  taken  place, 
into  the  skin  and  beneath  it,  has  often  the  best  effect  by  virtue  of 
its  depletive  and  derivative  action.  Active  friction  of  the  limbs 
to  improve  their  circulation  and  increase  their  temperature  is  also 
useful. 

Tracheotomy.  When  suffocation  becomes  imminent  not  a 
moment  mu.st  be  lost  in  performing  tiacheotomy.     This  operation 


I20  Veterinary  Medicine. 

is  always  available  in  threatened  suffocation  from  obstruction  to 
the  passage  of  air  in  the  nostrils  and  throat. 

Different  methods  of  opening  the  windpipe  have  been  resorted 
to.  One  is  by  means  of  a  cannula  and  trochar  at  least  three-fourths 
of  an  inch  in  diameter  and  about  five  inches  long  and  with  two 
large  oval  orifices  in  the  middle  of  the  cannula,  and  on  opposite 
sides.  This  is  made  to  transfix  the  windpipe  with  its  investing 
skin  and  muscles  from  side  to  side  in  the  middle  of  the  neck,  care 
being  taken  to  pass  it  in  the  interval  between  two  adjacent  carti- 
laginous rings.  The  trochar  is  now  withdrawn  and  the  orifice 
in  the  cannula  corresponding  to  the  interior  of  the  windpipe,  the 
animal  is  enabled  to  breath  freely  through  the  tube.  The  can- 
nula has  only  then  to  be  secured  in  its  place  by  a  tape  carried  round 
the  neck. 

The  more  common  plan  is  by  introducing  a  tube  through  a  circu- 
lar opening  made  in  the  trachea.  For  this  operation  are  needed, 
sissors,  knife  with  a  thin  narrow  blade,  needle  and  thread,  and 
tracheotomy  tube.  The  common  tube  is  about  an  inch  in  di- 
ameter, four  to  five  inches  long  bent  upon  itself  so  as  to  fit  into 
the  trachea,  and  furnished  with  a  flat  shield  to  slits  in  which  cords 
may  be  attached  to  fix  it  in  its  place.  A  second  variety  is  only 
long  enough  to  reach  into  the  windpipe.  It  is  provided  with  a 
flattened  shield  externally  and  from  its  inner  extremity  projects 
downwards  at  right  angles  a  plate  curved  so  as  to  adapt  it  to  the 
form  of  the  interior  of  the  trachea.  There  is  an  additional  plate 
to  fit  into  the  upper  part  of  the  tube,  provided  with  two  lips  pro- 
jecting from  it  at  right  angles  ;  the  outer  lip  is  screwed  to  the 
shield  after  the  tube  has  been  introduced  into  the  wind  pipe  and 
the  inner  lip  is  thus  fixed  inside  the  ring  of  the  trachea,  immedi- 
ately above  the  opening  and  effectually  prevents  any  displacement 
of  the  tube. 

In  operating  the  animal  is  kept  standing  with  the  head  as  nearly 
as  possible  in  the  natural  position.  The  hair  is  removed  from  the 
skin  beneath  the  windpipe  between  the  middle  and  upper  thirds 
of  the  neck.  The  skin  having  been  rendered  tense,  (without  dis- 
placement) by  the  fingers  and  thumb  of  the  left  hand,  an  incision 
is  made  in  the  median  line  from  above  downwards,  for  about  two 
inches  and  is  carried  through  the  muscles  so  as  to  expose  two 
rings  of  the  trachea.     The  needle  and  thread  are  passed  through 


Lary7igitis  in  the  Horse.  121 

the  membrane  connecting  the  two  rings,  and  with  the  knife  a 
semicircular  piece  of  cartilage  is  cut  from  each  of  the  two  adjacent 
rings.  The  thread  in  the  connecting  membrane  prevents  them 
from  being  drawn  in  by  the  rush  of  air.  It  only  remains  to  intro- 
duce the  tube  and  fix  it  in  position. 

Not  only  does  tracheotomy  obviate  immediate  danger  of  suffoca- 
tion, but  by  removing  the  source  of  irritation  in  the  continuous 
and  forcible  rush  of  air  through  the  narrowed  and  inflamed  tube, 
and  in  securing  for  the  blood  a  freer  aeration  and  a  purer  consti- 
tution it  often  induces  a  rapid  change  for  the  better  ia  the  charac- 
ter of  the  inflammatory  action.  The  wound  may  be  daily  cleansed 
and  dressed  with  sodium  hyposulphite. 

Some  veterinarians  following  the  example  of  Bretonneau  and 
Trousseau  have  treated  sore  throat  from  the  first  by  what  is  called 
the  abortive  treatment.  For  this  purpose  a  long  whalebone  prob 
with  a  pledget  of  tow  firmly  attached  to  its  end  and  covered  with 
powdered  alum  is  introduced  through  the  mouth  into  the  pharynx 
and  larynx  even.  Violent  paroxysms  of  coughing  are  induced, 
but  cures  are  affected  in  from  two  to  five  days.  Under  Delafond's 
treatment  calves  and  foals  recovered  in  twenty-four  hours.  A 
more  modern  method  is  to  inject  a  solution  by  means  of  a  hypo- 
dermic syringe  inserted  between  the  upper  rings  of  the  trachea. 

Milder  treatment  such  as  the  inhalation  for  an  hour  several 
times  a  day,  of  the  fumes  of  burning  sulphur  and  water  vapor 
will  be  found  generally  successful.  The  air  should  be  impreg- 
nated with  sulphur  fumes  only  so  far  as  can  be  breathed  without 
inducing  coughing  on  the  part  of  the  patient.  Such  measures 
should  not  divert  attention  from  the  necessity  for  general  care,  a 
control  of  diet,  clothing,  air,  the  state  of  the  bowels,  nor  from 
local  external  applications  to  the  throat. 

Treatment  of  Chronic  Laryngitis.  The  patient  should  have 
a  loose  airy  box  with  an  equable  temperature.  The  avoidance  of 
work  and  exposure  must  be  sought  for  the  time.  Green  food, 
cut  roots,  boiled  grain,  or  bran  mashes,  with  little  or  no  hay,  or 
other  dry  food,  must  be  given.  The  bowels  must  be  regulated. 
An  electuary  compound  of  linseed  meal,  molasses,  and  a  drachm  of 
belladonna  extract  to  every  tablespoonful  of  the  mixture,  may  be 
given  to  the  extent  of  a  tablespoon ful  smeared  on  the  inner  side 
of  the  cheek  twice  daily.     A  mustard  poultice  to  the  throat  has 


122  Veterinary  MediciJie. 

often  a  good  effect.     Light  firing  over  the  lar^-nx  is  sometimes 
beneficial. 

If  secretion  is  defective  and  cough  hard  and  dry  chloride  of 
ammonium,  carbonates  or  bicarbonates  of  soda,  potash  or  ammon- 
ium or  borax,  in  solution  or  in  gaseous  form,  may  be  given,  the 
various  bitters  being  at  the  same  time  drawn  upon  as  tonics.  If 
secretion  is  excessive,  with  a  loose  gurgling  cough,  astringents  are 
indicated  like  ferric  sulphate  or  chloride,  (^  dr.),  or  they  may 
be  applied  as  spray  :  alum  or  iron  alum  five  grains  to  the  ounce, 
zinc  .sulphate  or  sulphocarbolate  two  grains  to  the  ounce,  .silver 
nitrate  one-half  grain  to  the  ounce.  These  may  be  introduced 
through  the  nose  with  the  head  elevated,  or  in  small  genera 
through  the  fauces.  Tar,  oil  of  tupentine,  creosote,  carbolic  acid 
or  eucalyptol  may  be  inhaled  from  hot  water. 


PHARYNGO— LARYNGITIS  IN  CATTLE. 

Susceptibility.  Causes,  symptoms,  cough,  salivation,  wheezing,  lach- 
rymation,  muzzle  dry,  tender  throat,  dysphagia,  disturbed  innervation  and 
circulation,  hyperthermia.  Duration.  Abscess.  Treatment,  laxative, 
local  treatment,  lancing 

Cattle  are  less  subject  to  sore  throat  than  honses.  The  skin 
appears  less  sensitive  to  the  influences  of  cold  and  heat.  The  ox 
is  not  subjected  to  the  same  severe  exertions.  It  is  rarely  seen  to 
sweat,  the  moisture  pa,ssing  off  from  the  surface  as  insensible 
perspiration  only.  The  disease,  however,  recognizes  the  same 
causes  as  in  the  horse,  though  these  are  manifestly  less  injurious. 

Symptoms.  The  disease  usually  affects  at  once  the  larynx  and 
pharynx  so  that  the  symptoms  are  somewhat  modified.  In  the 
simplest  form  there  is  only  a  small,  hacking  cough,  a  flow  of 
saliva  from  the  mouth  and  some  loss  of  appetite  but  no  fever. 
In  more  acute  cases  the  breathing  is  loud  and  wheezing,  the 
cough,  soft  and  rattling,  is  followed  by  a  free  discharge  of  mucous 
from  the  mouth,  the  nostrils  and  eyes  are  red,  the  muzzle  dry, 
the  pulse  accelerated  and  full,  the  throat  tender  to  the  touch,  and 
swallowing  difficult,  part  of  the  food  and  drink  being  rejected 
through   the   nose.     If  the  larynx   is  chiefly    involved  the  loud 


Laryngitis  in  Sheep.  123 

noise  in  breathing  is  the  predominant  symptom  and  sometimes 
almost  the  "only  one. 

Course,  etc.  The  cough  and  other  symptoms  are  usually  mod- 
erated with  the  access  of  the  abundant  secretion  on  the  second  or 
third  day,  and  recovery  is  perfect  on  the  eighth  to  the  fifteenth. 
If  abscess  results,  to  which  there  is  a  far  greater  liability  than  in 
the  horse,  it  may  not  burst  till  the  twentieth  day  and  the  case  is 
correspondingly  protracted.  This  should  be  carefully  distin- 
guished from  the  deposits  of  tubercle  which  take  place  around 
the  throat  in  cattle.     In   rare  cases  the  disease  becomes  chronic. 

Treatment  does  not  differ  from  that  advised  for  the  horse  ex- 
cept in  the  greater  safety  of  purgatives  which  must  in  this  case 
be  saline  (Epsom  or  glauber salts  one  to  two  pounds),  and  in  the 
greater  ease  with  which  local  treatment  can  be  applied  owing  to 
the  shortness  of  the  soft  palate.  When  abscess  forms  it  must  be 
encouraged  by  poulticing  and  opened  with  the  knife  or  lancet  as 
soon  as  it  points. 


I.ARYNGITIS  IN  SHEEP. 

Infrequency.  Causes,  damp  lands,  storms,  close  buildings,  clipping. 
Symptoms,  cough,  sneezing,  discharge,  snuffling,  oral  breathing,  tender 
throat.     Treatment,  ventilation,  warm  water  vapor,  sulphur  dioxide,  salines. 

Sore  throat  is  fortunately  even  more  rare  than  in  the  larger 
ruminants.  It  occurs  chiefly  where  this  animal,  constituted  to 
feed  on  the  dainty  grasses  of  the  dry  mountain  side,  is  kept  on 
cold,  marshy  ground  and  exposed  to  frequent  cold,  wet  blasts. 
Sheep  suffer  also  from  hot,  close,  filthy  buildings  in  winter,  and 
from  unseasonable  clipping. 

The  symptoms  are  frequent  coughing  and  sneezing,  running 
from  the  nose,  working  of  the  jaws,  and  breathing  through  the 
open  mouth  as  being  easier  than  through  the  plugged  nostrils. 
The  larynx  is  tender  and  may  be  swollen. 

Treatmeyit  is-  usually  confined  to  ventilation  and  cleansing  of 
the  fold,  frequent  fumigations  with  water  vapor  from  the  spout 
of  a  boiling  kettle,  and  with  sulphur  fumes,  and  giving  tepid 
farinaceous  gruels  or  mashes  containing  sulphate  of  soda  in  the 
daily  proportion  of  two  pounds  to  each  hundred  head  of  sheep. 
Sal  ammoniac  may  be  given  in  food  or  drinking  water. 


LARYNGITIS  IN  PIG. 

Frequency.  Causes,  wet,  cold  pens,  exposure,  withholding  liquids. 
Symptoms,  prostration,  dullness,  cough,  fever,  swollen  throat  and  neck, 
dyspnoea,  dark  mucosa,  sloughing  of  epithelium  and  epidermis,  general 
petechia?,  foetid  breath,  great  prostration.  Lesions,  gangrenous  patches 
on  pharynx  and  fauces,  ulcers,  infiltrations.  Treatment,  hygienic,  dietetic, 
emetic,  laxative,  poultice,  bandages,  locally,  astringent,  antiseptic,  caustic, 
tonic. 

Sore  throat  is  common  in  some  localities  when  pigs  live  in 
herds. 

Causes.  Chiefly  faulty  hygiene.  Exposed,  cold  and  wet  pig- 
geries, cold  blasts  for  which  the  pig  has  an  extraordinary  aver- 
sion, and  the  deprivation  of  liquids  in  warm,  dry  .seasons  are 
frequent  causes. 

Symptoms.  These  have  been  described  by  M.  Pradal,  who 
divides  the  disease  into  three  stages,  evidently  dealing  with  an 
infectious  malady.  The  first  stage  is  marked  by  loss  of  appetite, 
dullness,  slow,  listless  movements,  a  tendency  to  hide  under  the 
litter  ;  low,  hoarse  grunt  and  cough,  the  last  aggravated  by  mov- 
ing the  animal  ;  pain  in  swallowing  ;  red,  sunken  eye,  and  con- 
stipation. If  there  is  no  improvement  on  the  second  or  third  day 
it  merges  into  the  second  stage.  This  is  characterized  by  a  still 
hoarser  grunt,  painful,  hard  hacking  cough,  difficult  breathing, 
especially  in  the  sunshine,  and  a  rapidly  increasing  swelling  of 
the  throat,  soon  extending  to  both  ears  and  as  far  down  as  the 
breast  bone.  This  engorgement  feels  soft  and  pasty  though  firm, 
tender  lumps  may  be  felt,  indicating  the  approaching  formation 
of  abscess.  It  is  so  abuudant  that  suffocation  may  ensue  in  the 
course  of  forty-eight  hours.  If  the  progress  of  the  swelling  is 
not  arrested  it  soon  passes  into  the  third  or  gangre7ioiis  stage. 
The  breathing  is  more  hurried  ;  the  mouth  open,  the  protruded 
tongue  of  a  bluish  black  color,  the  cough  followed  by  a  contin- 
uous rattle,  the  head  unsteady,  swallov/ing  impossible,  and  the 
swelling  extends  to  the  side  of  the  face  and  beneath  the  chest. 
The  swollen  surface  is  cold  and  livid  ;  the  bristles  easily  detached  ; 
it  is  bedewed  by  a  sero.sity  which  exudes  from  it,  and  portions  of 
the  dead  skin  tend  to  detach  themselves.  The  mouth  and  throat 
124 


Laryngitis  i?i  Pig.  125 

participate  in  the  gangrene,  the  breath,  saliva  and  nasal  discharge 
is  fetid,  and  the  epidermis  peels,  off.  The  snout,  ears  and  skin 
generally  assume  a  bluish  black  hue,  the  prostration  is  extreme, 
the  creature  lying  constantly  on  its  side ;  the  pain  ceases  and  in 
one  or  two  days  death  ensues,  preceded  by  a  state  of  comparative 
calmness. 

On  opening  the  throat  after  death  the  mucous  membrane  is  en- 
gorged and  thickened,  bears  various  hues  of  black,  blue,  livid 
and  green,  and  breaks  dov\^n  into  a  pulpy  mass  under  slight  pres- 
sure. The  surrounding  (pharyngeal)  muscles  even  are  impli- 
cated in  this  change.  In  the  earlier  stages  there  is  only  engorge- 
ment with  blood  of  the  tonsils  and  the  mucous  membrane  of  the 
pharynx  and  larynx  ;  serous  infiltration  of  the  surrounding 
parts,  and  often  the  presence  of  inspissated  mucus  resembling 
false  membranes  or  of  ulcers  on  the  surface. 

Treatment.  In  the  earlier  stages,  hygienic  measures  alone 
may  suffice  to  check.  A  warm,  dry,  comfortable  piggery,  emol- 
lient and  astringent  drinks,  such  as  sheep's  head  broth,  oatmeal 
and  other  gruels  acidulated  with  vinegar  or  buttermilk,  an  emetic 
(six  grains  of  tartar  emetic)  ;  a  dose  of  physic  (four  croton 
beans  powdered  and  given  in  the  food,  or  from  two  to  three  ounces  of 
castor  oil),  and  if  the  patient  will  permit  it  a  flannel  bandage  or 
piece  of  sheepskin  round  the  throat.  If  the  symptoms  are  more 
threatening  it  is  recommended  to  bleed  from  the  ears  and  tail  ;  to 
apply  a  linseed  meal  poultice  round  the  throat  to  hasten  the 
formation  of  abscess,  or  in  the  absence  of  such  indications  to  em- 
ploy a  mustard  poultice  made  with  spirits  of  turpentine,  or  rugs 
wrung  out  of  boiling  water,  to  the  same  part.  I^ocal  astringent 
and  caustic  applications  to  the  throat  are  the  most  promising,  ap- 
plied by  means  of  a  whalebone  prob  as  recommended  for  other 
animals,  the  mouth  being  held  open  by  a  noose  round  the  upper 
jaw.  Sodium  sulphite,  silver  nitrate,  potassium  permanganate, 
hydrochloric  acid  diluted,  and  tincture  of  iodine,  may  be  em- 
ployed. 

When  the  gangrenous  stage  has  been  reached  all  treatment  is 
useless. 


LARYNGITIS  IN  THE  DOG. 

Sore  throat  is  chiefly  seen  in  pampered  pets  and  in  hunting 
dogs,  as  the  greyhound.  In  the  latter  class  it  is  the  result  of 
chills,  a  cold  ducking  when  heated,  cold  damp  kennels,  etc.  It  is 
sometimes  almost  the  only  manifestation  of  distemper. 

Symptoms.  Dullness,  impaired  appetite,  a  slight  cough  becom- 
ing more  frequent  and  paroxy.smal.  These  paroxysms  give  rise 
to  accelerated  and  panting  breathing,  and  if  severe,  to  the  ejection 
of  a  glairy  yellow  (bilious)  material  from  the  stomach.  There  is 
also  running  from  the  nose  and  frequent  sneezing.  The  dull 
muffled  bark  has  led  to  the  supposition  of  i-abies  but  it  has  no  re- 
semblance whatever  to  the  characteristic  cry  of  rabies  while  be- 
ginning like  an  impulsive  bark  merges  into  an  agonized  and 
baffled  howl.  Accelerated  pulse,  elevated  temperature,  reddened 
fauces  and  swollen  tonsils  are  marked  symptoms. 

Sometimes  a  short,  dry  cough  obstinately  remains  after  the 
disease  has  apparently  subsided. 

Treatment.  Attend  to  general  comfoi't,  steam  the  nostrils,  give 
a  laxative  if  costive,  and  follow  with  iodide  of  potassium  or  sal- 
ammoniac  (5  grains)  repeated  thrice  daily.  Apply  a  mustard 
poultice  to  the  throat. 


PHARYNGITIS.     SORE  THROAT. 

Causes.  Symptoms,  larynx  insensible,  tender  parotid  and  sub  maxillary 
swelling,  cough  mucous,  difficult  swallowing  with  gurgling,  liquids  re- 
turned by  nose,  baccal  mucosa  hot  and  red,  salivation,  chronic  cases. 
Treatment,  medicated  drinks  and  electuaries. 

ANGINA  PHARYNGEA.   CYNANCHE  PHARYNGEA. 

Inflammation  of  the  pharynx  ow^es  its  existence  to  the  same 
causes  as  Laryngitis. 

Symptojus.  The  general  symptoms  being  like  those  of  Laryn- 
gitis, the  specific  and  distinguishing  ones  only  will  be  here 
noticed.  The  larynx  is  not  tender  to  the  touch  nor  is  cough 
126 


Pharyngitis.     Sore   Throat.  127 

thereby  excited.  The  gl'Unds  beneath  the  root  of  the  ears  (paro- 
tids) are  swollen  and  tender  and  cough  is  induced  by  handling 
them.  The  intermaxillary  glands  are  enlarged.  The  cough  is 
loose  and  followed  by  the  ejection  of  glairy  materials  by  the  mouth 
and  nose.  Food  and  drink  are  swallowed  with  difficulty  and  eflfort, 
dry  grain  or  hay  is  often  refused,  or  dropped  from  the  mouth,  after 
it  has  been  chewed,  to  avoid  the  pain  of  swallowing.  Deglutition 
is  accompanied  by  a  gurgling  sound  caused  by  the  abundant  secre- 
tion in  the  pharynx.  In  swallowing  liquids  a  portion  is  often  re- 
jected by  the  nose.  The  mouth  is  hot,  red  at  its  back  part,  and  filled 
with  fetid  saliva:  which  often  drivels  from  between  the  lips  in  the 
coarser  breeds  of  horses.  The  fever  varies  according  to  the  in- 
tensity of  the  inflammation.  This  disease  is  rarely  serious,  and 
improvement  is  manifested,  by  a  free  discharge  from  the  nose  of 
a  white  opaque  color,  by  the  ability  to  swallow  without  pain,  and 
the  better  appetite  and  general  appearance.  Collections  of  pus  in 
the  Guttural  pouches  may  result  from  pharyngitis.  See  Chronic 
Nasal  Catarrh. 

Reynal  has  seen  chronic  cases  of  this  disease  due  to  :  ist,  frac- 
ture of  the  large  branch  of  the  hyoid  bone  ;  2nd,  Laceration  or 
ulceration  of  the  soft  palate  ;  and  3rd,  an  abscess  of  the  pharyn- 
geal mucous  membrane. 

The  treatmoit  does  not  differ  materially  from  that  of  laryngitis 
except  in  the  greater  value  of  soft  food,  mucilaginous  and  acid- 
ulated drink  and  of  electuaries  v>'hich  act  on  the  throat  as  they 
dissolve.     Subjoined  is  a  formula  : 

Recipe  :  Extract  Belladona,  four  drams  ;  potassium  iodide,  one 
ounce ;  sodium  hyposulphitis,  three  ounces  ;  mellis,  five  ounces. 
Mix.  A  desert  spoonful  to  be  smeared  on  the  inside  of  the  cheek 
thrice  daily. 


CROUP. 

Croup  :  croak.  Acute  laryngitis,  with  spasms  and  perhaps  pseudo-mem- 
branes. Relation  to  diphtheria.  Causes,  low,  damp  localities,  exposure, 
youth,  form  of  inflammation.  Symptoms,  onset  sudden,  crowing  inspira- 
tion, hard  cough  paroxysmal,  fever,  larynx  sensitive,  dyspnoea  in  paroxysms 
or  intermittent.  Complications.  Duration.  Lesions,  intense  congestion, 
false  membranes  on  larynx,  fibrinous.  Treatment,  fomentations,  ether, 
chloroform,  chloral  hydrate,  laxative  saline,  sedative,  derivative,  surgical, 
water  vapor,  calomel,  caustic,  stimulants,  tonics.  Croup  in  sheep  and 
horse. 

CROUPOUS  LARYNGITIS.       PSEUDO- MEMBRANOUS  LARYNGITIS. 

Name  and  Definition.  The  word  croicp  by  which  this  disease 
is  known  over  the  whole  of  Europe  and  a  great  part  of  America 
is,  essentially  Scotch,  and  is  familiarly  used  in  the  I^owlands  of 
Scotland  to  .signify — to  croak.  The  disease  consists  in  an  acute 
inflammation  or  high  vascular  irritation  of  the  larynx,  associated 
with  spasms  of  its  muscles  and  commonly  though  not  invariably 
with  a  firm  layer  of  exudation  on  the  surface  of  the  mucous  mem- 
brane. In  some  cases  undoubtedly  croup  is  but  a  form  of  the 
contagious  pseudo-membranous  affection  diphtheria,  the  germs  of 
which  grown  on  a  surface  freely  swept  by  continuous  currents  of 
pure  air,  retain  too  much  of  an  aerobic  habit  to  penetrate  deeply 
into  the  tissues.  (See  Authors,  "  Malignancy  mitigated  by 
Oxygen,"  Medical  Record,  1881,  p.  673).  It  does  not  follow, 
however,  that  croup  is  always  due  to  even  a  weakened  germ.  So 
far  as  yet  appears  it  may  develop  independently  of  any  particular 
pathogenic  germ,  from  some  violent  local  irritant  in  a  predisposed 
subject.  Croup  therefore  may  be  treated  here  as  a  presumably 
noninfectious  di.sease.  Being  a  very  rare  disease  in  horses  its 
manifestation  in  ruminants  will  first  be  noticed. 

CROUP   IN    THE   ox. 

Causes.     These  are  not  well  understood.     L,ow,  damp  situations 

would  seem  most  liable,  especially  if  the  animals  are  much  exposed 

at  night.     So  far  indeed  as  can  be  ob.served  it  arises  from  the  same 

causes    as  laryjigitis.     Age  affects    its    development.     Croup   is 

128 


Cronp.  129 

mostl}''  seen  in  animals  between  six  months  and  a  j^ear  old,  and 
rarely  in  those  over  five  or  six  years  of  age.  The  specific  cause 
of  the  formation  of  false  membranes  and  of  spasms  of  the  laryn- 
geal muscles  is  a  mystery,  but  to  these  the  susceptible  constitution 
and  tissues  of  young  animals  appear  to  predispose.  No  mere 
grade  of  inflammation  from  the  slightest  hypergemia  to  the  high- 
est type  of  inflammatory  action  is  of  itself  sufficient  to  arouse  the 
special  phenomena.  All  of  these  are  seen  everywhere  but  croup 
may  be  said  to  be  confined  to  certain  localities  and  ages. 

Symptoms.  Unless  it  supervenes  on  a  pre-existant  attack  of 
catarrh,  croup  is  usually  as  sudden  in  its  outset  in  the  lower  ani- 
mals as  in  man.  An  extremely  hard  croupy  cough,  or  loud, 
crowing,  difficult  breathing,  loudest  in  inspiration,  is  usually  the 
first  symptom  and  appears  to  seize  the  animal  in  an  instant  and 
without  the  slightest  premonition.  This  is  closely  followed  b}- 
intense  fever,  full,  hard  pulse,  80  to  100  and  upward  per  minute, 
increase  of  bodily  temperature  sometimes  to  107.5°  F. ,  costive- 
ness  and  high  colored  scanty  urine.  The  throat  is  excessively 
tender,  the  slightest  touch  giving  rise  to  violent  paroxysms  of 
coughing,  during  which  the  eyes  redden  and  protrude  from  their 
sockets,  the  veins  of  the  skin  are  gorged,  the  tongue,  dry  and  livid, 
is  protruded  and  small  portions  of  the  contents  of  the  stomach  and 
white  shreds  of  false  membrane  are  occasionally  brought  up. 
Sometimes  in  the  intervals  of  coughing  as  well  the  mouth  is  con- 
stantly open  and  the  tongue  protruded  and  partly  covered  by  a 
frothy  but  tenacious  mucus.  Suffocation  appears  imminent  in 
many  cases  and  the  beast  may  perish  suddenly  in  this  way.  On 
the  other  hand  the  threatening  symptoms  may  be  present  only  at 
certain  periods  of  the  day  and  may  be  moderated  remarkably  at 
others,  especially  at  early  morning.  If  complicated  by  any  chest 
affection  the  symptoms  are  more  urgent  and  the  issue  more  com- 
monly fatal.  If  associated  with  a  low  type  of  fever,  a  small,  weak 
pulse,  and  much  prostration,  as  it  tends  to  be  if  it  continues  sev- 
eral days  without  relief,  it  has  a  more  fatal  tendency.  The  same 
may  be  said  of  its  occurrence  epizooticall3^ 

Duration.  Croup  will  often  run  its  course  and  prove  fatal  in 
twenty-four  to  forty-eight  hours.  Improvement  is  manifested  by 
the  cough  becoming  less  convulsive  and  painful,  by  the  ex- 
pulsion through  the  mouth  of  shreds  of  false  membrane,  and  by 
return  of  spirits  and  appetite. 
9 


130  Vctermary  Medicine. 

Postmortem  Appearances.  If  the  animal  has  died  suffocated,  the 
lungs  and  right  side  of  the  heart  will  be  gorged  with  blood  ;  if  in 
a  stupor  (coma),  attendant  on  brain  poisoning  with  venous  blood, 
the  veins  will  be  specially  engorged.  The  mucous  membrane  of 
the  larj'nx  has  a  more  vivid  arborescent  redness  than  in  ordi- 
nary laryngitis  but  the  special  feature  is  the  presence  of  false 
membranes.  These  layers  of  exuded  material  are  almost  confined 
to  the  air  passages.  They  may  extend  to  the  soft  palate  and  nose 
in  an  upward  direction  and  to  the  trachea  and  bronchial  tubes  in  a 
downward,  but  they  rarely  exist  in  the  mouth,  pharnyx,  or  gullet 
like  the  false  membranes  of  diphtheria. 

Characters  of  the  false  membranes.  These  are  gra)'  or  yellow- 
ish white,  though  they  may  be  reddened  in  patches  or  streaks. 
They  vary  in  consistency  from  that  of  glairy  mucus  to  a  firm  layer 
as  of  dense  fibrine,  and  become  more  adherent  as  they  are  of  old- 
er standing.  Sometimes  they  are  partially  detached,  the  free  end 
of  the  shreds  floating  in  the  larynx.  The  deep  or  attached  sur- 
face presents  redness  in  points,  in  streaks,  or  as  ramifications  very 
visible  if  the  membrane  is  held  up  between  the  eye  and  the  light. 
They  vary  in  thickness  from  half  to  a  line.  Delafond  has  found 
these  membranes  in  the  lower  animals  to  be  mostly  formed  of  fi- 
brine, with  a  little  albumen,  and  traces  of  alkaline  and  earthy 
salts. 

Trcatinent.  This  must  be  prompt  and  energetic.  Wet  cloths 
as  hot  as  the  hands  can  bear,  wrapped  around  the  throat  and  neck, 
and  replaced  as  they  cool,  will  usuall}^  arrest  the  spasm.  If  this 
fails  ether  or  chloroform  by  inhalation  or  chloral  hydrate  by  in- 
jection may  be  employed  with  caution.  The  action  of  the  bowels 
must  be  secured  by  salines  (sulphate  of  soda  yi  to  i  lb)  or  oil 
(linseed  oil  Yz  to  i  pint)  and  injections  of  warm  water.  Sulphate 
of  soda  should  be  thereafter  given  in  half  ounce  doses  twice  daily, 
or  nitrate  or  acetate  of  potass  may  be  substituted.  They  are 
advantageously  given  in  linseed  decoction  and  may  be  combined 
with  laudanum,  (>^  ounce),  belladonna,  or  other  agent  to  check 
the  spasms. 

A  blister  (mustard  poultice)  should  be  applied  at  first  either  to 
the  throat  or  breast,  the  windpipe  being  left  untouched  lest 
tracheotomy  .should  be  required.  Similar  applications  to  the  legs 
are  useful. 


Cro2ip.  131 

If  suffocation  appears  imminent  tracheotomy  should  be  at  once 
performed  Csee  under  L,ar3'ngitis).  This  operation  has  been  de- 
preciated because  of  the  late  period  at  which  it  has  been  employed, 
when  the  patient  was  already  past  all  hope,  but  the  resulting 
wound  in  the  neck  is  more  than  counterbalanced  by  the  greater 
freedom  of  breathing  and  the  better  aeration  of  the  blood  which 
tends  to  obviate  the  justly  dreaded  low  fever.  It  often  leads  to  a 
rapid  diminution  of  the  spasms  and  laryngeal  irritation. 

Agents  applied  directly  to  the  inflamed  mucous  membrane  are 
often  requisite.  The  air  of  the  building  should  be  rather  warm, 
equable  and  moistened  by  water  vapor,  if  that  can  be  conveniently 
done.  Calomel  or  alum  powder  may  be  frequently  introduced 
into  the  larjmx  by  means  of  a  whalebone  prob  and  sponge  as 
spoken  of  under  laryngitis,  or  a  solution  of  nitrate  of  silver  (10 
grains  to  the  ounce  of  water)  may  be  applied  several  times  a  day. 
These  not  onl)'  hasten  the  removal  of  false  membranes  but 
counteract  their  production.  The}'  produce  violent  and  convul- 
sive coughing  at  first  and  have  to  be  used,  carefully.  Delafond 
blew  in  such  agents  through  an  opening  made  in  the  windpipe. 
They  may  be  injected  with  a  hyperdermic  syringe.  In  prostrate 
conditions  it  may  be  necessary  to  resort  to  stimulants  (wine  whey, 
carbonate  of  ammonia)  and  tonics  (gentian,  Peruvian  bark). 

CROUP    IN    SHEEP. 

According  to  Roche  Lubin  croup  is  sometimes  observed  in 
spring  in  lambs  and  hogs.  The  common  cause  is  ' '  the  shutting 
up  of  the  animals  for  the  whole  twenty-four  hours  in  a  hot  con- 
fined place,  the  floor  of  which  is  covered  by  a  fine  dust,  and  the 
air  loaded  with  the  same,  owing  to  the  jostling  of  the  sheep  to- 
gether, the  effects  being  intensified  by  the  weight  of  the  fleeces." 

The  disease  is  manifested  by  constant  working  of  the  jaws,  ex- 
treme tension  of  the  neck,  abundant  salivation,  respiration  hur- 
ried and  whistling,  extreme  pain  and  threatened  suffocation  when 
the  slightest  pressure  is  made  on  the  throat,  and  refusal  of  all 
food  liquid  or  .solid.  The  weak,  hacking,  convulsive  cough  is 
associated  with  the  discharge  of  a  whitish  glairy  mucus  by  the 
no.se  until  the  third  or  fourth  day  when  false  membranes  may  be 
expected. 


132  Veterinary  Medicine. 

Treatment  is  like  that  for  the  ox,  medicine  being  given  in 
about  one-fifth  of  the  doses. 

CROUP   IN   THE   HORSE. 

The  rare  cases  of  croup  in  foals  and  young  horses  appear  due 
to  the  same  general  causes  as  in  ruminants.  M.  Riss  records  two 
cases,  and  Bonley  one  from  breathing  smoke  when  the  straw  of 
the  stable  had  taken  fire.  The  suddeness  of  the  attack,  the  spas- 
modic symptoms  and  the  duration  of  the  disease  and  the  treat- 
ment do  not  differ  materially  from  those  given  for  the  ox. 


PHARYNGEAL  AND  LARYNGEAL  POLYPI. 

Pediculated  tumors.  Dyspnoea  through  change  of  position,  operation  by 
ecraseur,  snare,  or  cricoid  incision. 

Tumors  of  varied  structure  developing  in  or  beneath  the  muco- 
sa of  pharynx  or  larynx  often  become  slowly  detached  until  they 
hang  by  a  loose  pedicle,  and  having  much  latitude  of  movement 
they  may  at  times  slip  between  the  arytenoid  cartilages  or  even 
into  the  glottis  producing  the  most  urgent  or  even  fatal  dyspnoea. 
Pediculated  tumors  in  the  posterior  nares  lead  to  the  same  acci- 
dent. In  one  case  of  multiple  small  tumors  on  the  pharyngeal 
mucosa  of  the  horse,  the  largest  and  loosest,  attached  to  the  front 
of  the  epiglottis,  was  occasionally  displaced  into  the  larynx 
threatening  instant  asphyxia.  One  such  attack  supervened  on 
the  opening  of  a  suppurating  guttural  pouch  by  the  writer,  neces- 
sitating prompt  tracheotomy.  A  time  was  set  for  the  removal  of 
the  polypus,  but  the  tracheotomy  tube  having  been  accidentally 
displaced  during  the  preceding  night  the  patient  died  of  suffoca- 
tion. Dick  mentions  a  polypus  growing  from  the  interior  of  the 
larynx  and  causing  loud  roaring.  Such  tumors  may  be  removed 
by  operating  with  the  ecraseur  through  the  mouth,  or  by  a  snare 
passed  through  a  long  narrow  tube  and  used  to  seize  and  twist 
through  the  pedicle.  If  the  polypus  grows  from  the  laryngeal 
walls,  it  may  be  best  reached  by  incision  through  the  cricoid 
cartilage  and  crico-thyroid  membrane  as  in  the  operation  for 
roaring. 


DYSPNCEA  IvARYNGEA.     ROARING.     HEMIPI.EGIA 
EARYNGEA. 

Generic  name  for  common  symptom.  Low  and  high  notes.  Grunter, 
roarer,  whistler,  piper,  highblower.  Pace  or  effort  develops.  Causes  : 
of  temporary  roaring,  inflammations,  abscess,  phlebitis,  choking,  dropsy, 
petechial  fever,  phlegmons  along  vagus.  Causes  of  inveterate  roaring, 
paresis  of  left  recurrent  laryngeal  nerve,  fatty  degeneration  of  left  arytenoid 
muscles,  fracture  of  facial  bones,  polypi  in  air  passages,  chronic  thickening 
of  mucosa,  foreign  bodies  in  passages,  tumors  of  lymph  glands,  abscess  of 
guttural  pouches,  pseudo  membrane,  laryngeal  ulceration,  ossification,  dis- 
tortion, fracture  of  cartilages,  action  of  forcible  inspiration,  leading  on  left 
side,  deep  origin  of  reccurrent  nerve,  effect  of  chest  diseases  and  violent 
heart  action,  examples  of  morbid  conditions  impairing  innervation.  Le- 
sions in  muscles,  and  nerves.  Facial  palsy,  poison  (chick  vetch,  winter 
vetch,  lead,  fungi,  moulds).  Intermittent  roaring.  Hereditary  roaring. 
Symptoms,  grunting  when  coughed  or  threatened,  heavy  draft,  galop,  noise, 
larnygeal  tremor,  cold  as  a  complication,  roaring  with  expiration,  lesions. 
Treatment,  its  use.  Prevention,  avoid  breeding  roarers,  bearing  reins, 
chick  vetch,  lead.  Tonic  medication,  caustic  to  mucosa,  firing,  setons, 
iodine,  pad  nostrils,  tracheotomy,  arytenectomy,  electricity. 

This  is  the  name  of  a  symptom  rather  than  a  disease.  It  im- 
plies a  sound  made  in  breathing  in  connection  with  some  contrac- 
tion of  the  air  passages.  The  term  is  however  usually  reserved 
for  those  conditions  in  which  the  sound  results,  from  chronic  dis- 
ease or  malformation,  the  noise  attendant  on  laryngitis  and  other 
acute  diseases  being  rarely  spoken  of  as  roaritig.  In  neither  case 
does  the  noise  indicate  more  than  that  there  is  some  impediment 
to  the  ingress  and  egress  of  air  through  larynx  or  trachea. 

The  pitch  of  the  note  varies  exceedingly  with  the  causes  that 
prodtice  it  and  with  the  hurried  nature  of  the  breathing.  There 
have  thus  arisen  the  epithets  of  grunter,  roarer,  whistler,  high- 
bloiver,  piper,  trumpeter,  ivheezer,  etc.  The  most  common  dis- 
tinctions are  those  of  roaring  and  whistling.  The  r^(a;r<?r  produces 
a  loud  deep  basso  .sound  in  in,spiration,  the  larynx  or  windpipe 
being  only  slightly  narrowed  while  the  whistler  or  piper  produces 
a  shrill  blowing  or  sibilant  noise  because  of  the  greater  constric- 
tion of  the  passage.  The  term  grunter  is  derived  from  the  facts 
that  a  roarer  usually  makes  a  grunting  noise  when  struck  or 
threatened  with  a  cane,  and  that  when  the  tipper  cartilages  of  the 
133 


134  Vetcrijiary  Medicine. 

windpipe  are  pinched  between  the  finger  and  the  thumb  the  re- 
sulting cough  is  prolonged  and  somewhat  like  ^g-runt.  A  wheczer 
is  usuall}-  suffering  from  spasmodic  contraction  of  the  bronchial 
tubes,  from  broken  wind  or  from  chronic  bronchitis.  A  high- 
blower  s\\o\AdL  never  be  spoken  of  in  the  same  connection,  as  the 
noise  is  made  from  a  playful  flapping  of  the  false  nostrils  or  soft 
palate  and  disappears  when  the  animal  is  put  to  the  top  of  his 
speed.  It  is  from  confounding  highblowing  with  roaring  that 
Eclipse  and  other  brilliant  performers  on  the  English  turf  have 
been  erroneously  pronounced  roarers. 

The  noise  produced  by  the  roarer  is  not  heard  while  he  stands 
quiet,  nor  many  cases  even  during  a  short  trot  or  gallop.  Such 
horses  are  in  consequence  often  sold  at  the  hammer  and  the  pur- 
chaser is  grievously  disappointed  to  find  that  what  he  thought  a 
sound  horse  is  absolutely  useless  for  the  purpose  for  which  he  de- 
signed it. 

Causes.  Before  noticing  the  symptoms  of  roaring  a  considera- 
tion of  the  causes  will  be  useful  to  enable  the  reader  the  better 
to  understand  the  signs  by  which  the  different  forms  are  mani- 
fested. 

Causes  of  temporary  roaring.  Whatever  impedes  the  cur- 
rent of  air  causes  roaring.  Hence  inflammatory  diseases  of  the 
nose,  throat,  windpipe  or  bronchial  tubes  ;  abscess  of  one  or  the 
other  of  these  parts  ;  inflammation  of  a  jugular  vein  and  pressure 
on  the  trachea  or  vagus  nerve  by  the  resulting  swelling  ;  choking; 
the  swelling  in  the  neck  consequent  on  the  cutting  open  of  the 
gullet  for  the  relief  of  choking  ;  thickening  of  the  nostrils  from 
dropsy,  loss  of  a  jugular  vein,  purpura  hemorrhagica  etc.  ;  and 
swellings  pressing  on  the  vagus  nerve,  and  which  may  be  situated 
at  the  base  of  the  brain,  in  the  neck  or  in  the  anterior  part  of  the 
chest.     Also  temporary  infiltration  of  the  laryngeal  mucosa. 

Causes  of  inveterate  roaring.  The  one  great  cause  of  roar- 
ing and  that  which  sustains  the  disease  in  nineteen  cases  out  of 
every  twenty  is  paralysis  of  the  left  recurrent  nerve  of  the  larynx 
and  wasting  of  several  of  the  arytenoid  muscles  on  that  side.  It 
may  be  well,  however,  first  to  notice  the  less  frequent  causes  and 
wind  up  with  this  more  common  one.  ist,  Fracture  with  distor- 
tion of  the  nasal  bones  and  narrowing  of  the  nasal  passages 
(Gamgee).     2nd,  Polypi  and  other  tumors  of  the  nose,  pharynx, 


Dyspncea  La>'yngca.     Roaring.     Hemiplegia  Laryngca.    135 

larynx,  windpipe  or  bronchi.  3rd,  Chronic  thickening  of  the 
nasal  mucous  membrane,  the  result  of  inflammation.  4th,  The 
presence  of  foreign  bodies  in  the  nose,  as  for  example  balls 
coughed  up  from  the  pharynx.  5th,  Hering  records  a  case  re- 
sulting from  the  closure  of  the  posterior  opening  of  one  nasal 
chamber  by  a  membrane.  6th,  Cancerous  or  melanotic  deposits 
in  the  lymphatic  glands  above  and  to  each  side  of  the  pharynx 
and  larynx.  7th,  Distension  of  the  guttural  pouches  by  inspis- 
sated pus.  8th,  Chronic  thickening  of  the  mucous  membrane  of 
the  larynx  consequent  on  inflammation.  9th,  The  formation  of 
a  projecting  fold  of  the  mucous  membrane  or  of  a  new  production 
(false  membrane)  in  the  windpipe  as  the  result  of  inflammation. 
Such  false  membranes  have  been  known  to  become  detached  at 
their  median  part  and  remain  attached  at  their  two  extremities  thus 
constituting  a  band  stretching  from  one  side  of  the  windpipe  to  the 
other.  loth.  Ulceration  of  the  membrane  of  the  larynx  particularly 
on  the  projecting  folds  circumscribing  the  glottis,  i  ith,  Ossifi- 
cation of  the  laryngeal  cartilages  and  loss  of  their  elasticity.  12th, 
Distortion  of  the  cartilages  of  the  larynx,  most  commonly  from 
unduly  tight  reining  and  pulling  the  nose  in  toward  the  chest. 
In  such  cases  the  cartilages  of  the  larynx  and  those  of  the  wind- 
pipe adjoining  being  compressed  slide  within  each  other,  and  the 
enclosed  edge  projecting  within  the  air  tube  materially  diminishes 
its  calibre.  13th,  Fracture  of  one  or  more  rings  of  the  trachea. 
This  usually  results  from  blows,  as  in  running  the  neck  against 
the  back  of  a  cart  or  wagon.  The  cartilaginous  rings  are  usually 
broken  at  their  median  part  in  front  and  being  retained  together 
by  the  investing  elastic  tissue  which  enables  the  pieces  to  move 
on  each  other  as  by  a  hinge,  and  being  approximated  by  the  con- 
traction of  the  trachealis  muscle  above,  the  ring  is  flattened  from 
side  to  side  and  the  channel  for  the  passage  of  air  correspondingly 
decreased.  This  flattening  can  be  easilj^  felt  by  the  hand  in  the 
living  horse.  14th,  A  peculiar  congenital  distortion  of  the 
trachea  caused  by  the  curling  in  of  one  end  of  each  cartilage  of 
the  windpipe  and  the  straightening  out  of  the  other.  This  occa- 
sionally proceeds  so  far  that  the  gullet  is  lodged  in  the  interspace 
overlapped  and  hidden  by  the  free  ends  of  the  cartilages,  the  di- 
ameter of  the  windpipe  being  proportionately  diminished.  Dis- 
tortions and  fractures  are  usually  overlooked  by  veterinarians  but 


136  Veterinary  Medicine. 

from  the  frequency  with  which  the  author  has  met  with  them  in 
his  dissection  he  is  convinced  that  they  deserve  greater  attention 
than  has  been  awarded  them.  15th,  Percivall  records  a  case  of 
inveterate  roaring  in  which,  even  tracheotomy  having  failed  to 
cure,  the  patient  was  destroyed  and  the  kings  found  to  be  exten- 
sively consolidated,  many  of  the  air  tubes  having  been  so  com- 
pressed as  to  be  almost  impervious.  I  have  known  a  case  of 
roaring  from  the  presence  of  a  pedunculated  tumor  in  the  lower 
end  of  the  windpipe  where  it  divides  to  enter  the  lungs,  and  the 
same  result  may  ensue  from  the  partial  obstruction  of  the  bron- 
chial tubes  by  masses  of  tenacious  mucus  in  chronic  bronchitis. 

1 6th.  The  immediate  cause  of  roarijig  in  the  immense  majority 
of  cases  is  the  paralysis  and  fatty  degeneration  of  certain 
muscles  on  the  left  side  of  the  larynx.  The  muscles  supplied 
with  motive  power  by  the  left  recurrent  laryngeal  nerve 
(Crico-arytenoideus  posticus,  Crico-arytenoideus  lateralis,  thyro- 
arytenoideus,  and  the  left  half  of  the  arytenoideus)  are  those 
constantly  and  exclusively  affected,  while  those  supplied  by  the 
siiperior  laryngeal  nerve  (Crico-thyroideus,  hyo-thyroideus  and 
hyo-epiglottideus)  remain  unchanged.  The  left  recurrent  nerve 
is  also  wasted  and  considerably  attenuated  as  compared  with  that 
on  the  opposite  side.  The  modus  operandi  of  this  paralj^sis  and 
wasting  in  the  production  of  roaring  is  beautifully  seen  when  the 
upper  part  of  the  windpipe  is  laid  open  so  as  to  expose  the  in- 
terior of  the  larynx  in  laryngectom\^  The  triangular  opening  of 
the  glottis  is  seen  fairly  dilated  while  the  muscles  are  relaxed  in 
the  act  of  expiration.  As  soon,  however,  as  inspiration  com- 
mences the  left  arytenoid  cartilage  slides  completely  into  the 
passage,  its  lower  border  projecting  so  much  to  the  right  that  it 
forms  a  prominent  crest  extending  beyond  the  median  line  and  in 
some  cases  closely  approaching  the  right  wall  of  the  larynx,  the 
superior  elastic  and  free  border  of  the  same  cartilage  meanwhile 
gets  drawn  inward  by  the  suction  power  of  the  air  so  as  to  block 
up  the  passage  still  more.  The  closure  of  the  glottis  being  thus 
seen  to  be  largely  controlled  by  the  current  of  inspired  air,  it  be- 
comes evident  that  any  increase  in  the  force  of  the  current  will 
aggravate  it  and  a  decrease  will  lessen  the  extent  of  the  closing 
and  alleviate  the  distress  of  breathing.  This  fact  furnishes 
a  means  of  palliating  the  symptoms.      (See  treatment.)     It  ex- 


Dyspncea  Laryngea.     Roaring.     Hemiplegia  Laryngea.     137 

plains  moreover  why  roaring  should  not  be  heard  in  quiet  breath- 
ing and  why  it  should  increase  in  force  and  in  pitch  as  the 
respiration  becomes  more  and  more  hurried.  It  further  accounts 
for  the  noise  being  heard  only  during  the  act  of  inspiration,  the 
outward  rush  of  the  air  in  the  expiratory  act  being  of  itself  suffi- 
cient to  carry  this  valvular  cartilage  out  of  the  passage  and  secure 
a  free  and  unimpeded  current. 

The  paralysis  and  wasting  of  the  left  recurrent  nerve  and 
muscles  are  in  their  turn  due  to  verj-  varied  morbid  states. 

It  may  commence  in  the  larynx  from  distortion  of  its  cartilages 
and  inflammation  of  the  mucosa,  in  which  case  the  wasting  of  the 
nerve  is  probably  a  result  of  its  prolonged  inactivity.  This  mode 
of  origin  is  strongly  insisted  on  by  Percivall,  and  no  doubt  occa- 
sionally arises.  Under  this  explanation,  however,  it  is  difficult 
satisfactorily  to  account  for  its  almost  invariable  occurrence  on  the 
left  side.  The  mere  fact  that  the  horse  is  habitually  approached 
on  this  side  and  more  commonly  turned  toward  it  is  a  most  in- 
sufficient rea.son. 

Even  if  admitted  it  utterly  fails  to  explain  the  immunity  of  the 
muscles  supplied  by  the  superior  laryngeal  nerve. 

The  fact  that  a  horse  has  usually  a  hard  and  soft  side  of  the 
mouth  and  carries  the  head  slightly  to  the  latter  is  no  better  ex- 
planation, as  the  tender  side  is  not  always  the  left. 

More  commonly  the  disease  arises  at  some  other  point  near  the 
origin  or  in  the  course  of  the  nerve,  and  the  changes  in  the  larynx 
follow  as  the  consequence  of  deficiency  or  entire  absence  of 
motor  innervation.  Many  cases  can  be  cited  in  which  such  an 
origin  was  unquestionable,  and  on  the  hypothesis  that  this  is  the 
true  and  constant  history  of  the  development  of  the  malady,  its 
regular  occurrence  in  the  left  side,  and  the  absence  of  all  signs  of 
wasting  in  the  muscles  supplied  by  the  superior  laryngeal  nerve 
are  alike  perfectly  explainable. 

Let  it  be  noted  that  the  vagus  nerves  (right  and  left)  of  which 
the  recurrent  laryngeal  are  branches,  originate  from  the  base  of 
the  brain,  pass  down  the  neck  beneath  the  jugular  vein  in  com- 
pany with  the  carotid  artery  ;  that  on  entering  the  chest  the  right 
vagus  nerve  gives  off  its  recurrent  branch  which  proceeds  at  once 
up  the  neck  along  the  course  of  its  parent  trunk  till  its  reaches 
the  larynx,  to  the  muscles  on  the  right  side  of  which  it  is  dis- 


138  Veterinary  Medicine. 

tributed  ;  that  the  left  vagus  nerve  on  the  other  hand  proceeds 
backward  in  company  with  the  left  innominate  artery  as  far  as 
the  base  of  the  heart,  where  on  about  the  level  of  the  space  be- 
tween the  sixth  and  seventh  ribs  it  gives  off  the  left  recurrent 
nerve  ;  that  this  left  recurrent  nerve  closely  applied  at  its  point  of 
origin  to  tlie  great  parent  arteries  turns  round  the  posterior  aorta 
enclosing  it  in  a  loop,  and  gaining  the  lower  end  of  the  windpipe 
follows  its  course  to  the  larynx.  It  will  thus  be  understood  how 
many  chest  diseases  may  implicate  the  left  recurrent  nerve,  and 
from  which  the  right,  which  extends  no  deeper  than  between  the 
two  first  ribs,  may  be  completely  exempt.  The  frequent  superven- 
tion of  roaring  as  a  sequel  of  chest  diseases  receives  in  this  an  ample 
explanation.  Its  connection  with  pleurisy  becomes  especially 
probable,  as  the  nerve  lies  in  contact  with  the  surface  of  the 
pleura  alike  in  its  descending  and  ascending  course  within  the 
chest. 

Finally  the  loop  encircling  the  posterior  aorta  exposes  the  nerve 
to  constant  stretching  and  shocks  from  the  heart's  action  during 
violent  exertions  and  in  excited  states  of  the  circulation  generally. 
Vaerst  and  Sussdorf  show  that  the  nerve  is  habitually  flattened 
between  the  posterior  aorta  and  trachea,  the  effect  being  worst 
when  the  heart's  action  is  excited. 

It  remains  to  notice  a  few  instances  in  which  dissection  estab- 
lished the  connection  of  interference  with  the  nerve  at  some  part 
of  its  course  and  the  existence  of  roaring. 

(a.)  Godine  found  in  a  roarer  a  tumor  about  the  size  of  a 
chicken's  ^%%,  pressing  on  the  commencement  of  the  pulmonary 
artery.  He  attributed  the  roaring  to  the  impaired  circulation  of 
blood  in  the  lungs  by  the  pressure  on  the  artery.  Considering 
that  the  tumor  must  have  been  precisely  in  the  situation  of  the 
left  recurrent  nerve  at  its  point  of  origin,  it  becomes  much  more 
probable  that  the  symptom  resulted  from  pressure  on  this  nerve. 

(b.)  The  elder  Bouley  found  in  one  case  a  considerable  engorge- 
ment of  the  group  of  lymphatic  glands  in  the  anterior  part  of  the 
chest  and  through  the  centre  of  which  the  left  recurrent  nerve 
passed. 

(c.)  Fergusson  of  Dublin  dissected  a  roarer  in  which  he  found 
besides  some  tumors  of  the  lymphatic  glands  in  the  pelvic  and 
sub-lumbar  regions,  an  indurated  and  enlarged  gland  about  four 


Dyspnoea  Laryiigca.     Roa?^i)ig.     Hemiplegia  Laryngea.     139 

inches  behind  the  anterior  opening  of  the  thorax.  The  recurrent 
nerve  between  this  and  the  larnyx  was  wasted  so  that  its  fibres 
could  scarcely  be  recognized,  the  laryngeal  muscles  on  that  side 
were  atrophied,  and  degenerated,  and  the  glottis  distorted  and 
partly  closed.  Fergus.son  has  in  his  description  made  the  mistake 
of  writing  the  right  for  the  left ;  it  is  evident  that  the  right  recur- 
rent nerve  could  not  possibly  pass  through  a  tumor  in  the  situation 
described. 

(d. )  Gamgee  furnishes  a  drawing  of  an  immense  tumor  filling 
up  the  anterior  part  of  the  chest,  pressing  on  the  vagi  and  recur- 
rent nerves  and  causing  roaring. 

(e. )  The  Clinique  of  the  Alfort  Veterinary  School  furnishes 
the  following  among  other  cases  of  roaring  consequent  on  inflam- 
mation of  the  jugular  vein.  A  well-bred  and  very  fast  English 
thoroughbred  had  been  used  for  two  5'ears  by  his  owner  who  was  a 
hard  rider.  In  June,  1857,  he  was  bled  as  a  preventive  (saignee 
de  precaution),  supurative  phlebitis  was  induced  and  was  only 
cured  at  the  end  of  six  weeks.  When  again  put  to  work  he 
proved  a  roarer  and  was  still  affected  when  seen  six  months  later. 

In  connection  with  this  it  may  be  noted  that  the  swelling  in 
connection  with  the  inflammation  of  the  vein  extends  easil}^  to 
the  sub-jacent  vagus  and  recurrent  nerves,  leading  to  their  inflam- 
mation, functional  inactivity  and  atrophy.  Bleeding  is  usually 
done  on  the  left  side  of  the  neck  so  that  the  paralysis  and  wasting 
would  still  be  on  the  same  side.  Happily  with  a  more  humane 
system  of  treatment,  accidents  of  this  kind  are  less  frequent  than 
formerl3^  Glockner  furnishes  a  case  which  followed  thrombosis 
of  the  carotid. 

(f)  Reynal  reports  several  cases  in  which  roaring  had  occurred 
as  a  sequel  of  inflammations  and  abscess  about  the  throat,  and  in 
which  infiltrations  or  gray  or  yellow  indurations  had  taken  place 
in  the  areolar  tissue  around  the  vagus  nerve.  As  nothing  is  more 
common  than  to  find  roaring  resulting  from  severe  sore  throat, 
parotitis,  etc. ,  this  may  explain  its  occurrence. 

Mandl  first  carefully  examined  the  paralyzed  muscles  which  pre- 
sent to  the  naked  eye  a  flattened  and  wasted  appearance  in  marked 
contrast  to  the  full  well-rounded  forms  or  those  on  the  opposite 
side.  They  differ  no  less  in  color.  In  place  of  the  deep  red  of 
the  healthy  muscles  those  on  the  diseased  side  are  of  a  yellowish 


142  Vete7'inary  Medicine. 

same  or  even  in  a  worse  condition,  the  larynx  meanwhile  un- 
naturall}'  compressed  between  his  narrow  jaws  and  the  nerve 
compressed  or  the  larynx  distorted. 

It  must  be  added,  however,  that  like  some  other  acquired  dis- 
tortions or  alterations  roaring  may  repeat  itself  in  the  progeny. 
Goodwin  mentions  an  instance  of  it  on  the  female  side  through 
three  successive  generations  of  thoroughbreds.  Of  transmission 
on  the  side  of  the  male  the  following  instance  is  noteworthy  : 
M.  Liphaert,  an  extensive  proprietor  in  lyivonia,  bought  a  first- 
class  English  thoroughbred  stallion.  His  progeny  were  healthy 
until  he  became  a  roarer  at  ten  years  old.  All  his  foals,  got  after 
this  date,  followed  the  sire  in  becoming  roarers,  and,  it  is  impor- 
tant to  observe,  almost  all  at  the  age  of  ten  years. 

Symptoms.  These,  of  course,  are  manifest  enough  while  the 
animal  is  sufficiently  excited  to  give  rise  to  the  noise.  Certain 
indications  may  be  obtained  even  while  the  animal  stands  in  the 
stable.  If  cough  is  excited  by  pinching  the  upper  rings  of  the 
windpipe  it  is  prolonged  into  a  groan.  If  suddenly  threatened 
with  a  cane  the  abrupt  inspiration  which  results  is  attended  by  a 
grimt.  The  absence  of  these  symptoms  is  not,  however,  suffi- 
cient to  establish  the  non-exi.stence  of  roaring.  The  horse  must 
be  galloped  or  put  to  heavy  draught  to  fully  test  the  breathing 
organs.  Galloping  up  a  steep  hill  is  perhaps  the  best  test.  A 
gallop  over  a  recently  ploughed  field  is  about  equally  good.  Soft 
pasture  land  or  an  unpaved  road  is  preferable  to  Macadam  or 
pavement.  Galloping  in  a  riding  school  on  the  soft  tan  is  an 
excellent  measure  as  the  sound  is  confined  and  the  animal  is 
always  within  earshot  of  the  examiner.  The  person  examining 
should  either  ride  the  horse  himself  or  have  a  disinterested  part}^ 
in  no  way  connected  with  either  buyer  or  seller,  to  mount  him. 
If  the  rider  is  in  the  interest  of  the  seller  he  may  contrive  to 
slacken  the  pace  before  he  reaches  the  examiner,  or  by  irritating 
the  horse  may  make  it  difficult  to  approach  him  immediately  on 
his  being  pulled  up.  If  in  the  interest  of  the  buyer  he  may  suc- 
ceed, by  the  u.se  of  a  powerful  bit,  in  drawing  the  horse's  nose  in 
to  the  chest,  or  by  compressing  the  larynx  with  a  tight  throat 
latch  he  may  produce  noise  in  breathing  when  the  animal  is  sud- 
denly brought  to  a  stand.  Unless  the  course  is  up  a  steep  hill  or 
over  a  ploughed  field  the  horse  should  be  galloped  for  from  five 


Dyspnoea  Laryngca.     Roarvig.     He?uiplegia  Lary^igca.     143 

to  ten  minutes  ;  he  should  be  then  made  to  pass  close  to  the  ex- 
aminer at  full  speed,  and  finally  brought  up  suddenly  by  his  side 
and  without  any  previous  slacking  of  his  pace.  The  ear  should 
be  at  once  placed  close  to  the  nostrils,  when  the  slightest  abnor- 
mal sound  accompanying  the  inspiratory  act  will  be  at  once 
recognized. 

Draught  horses  are  sufficiently  tested  by  driving  them  in  a 
heavy  vehicle  or  one  with  the  wheels  dragged.  By  walking 
alongside  or  keeping  the  ear  near  to  the  nostrils  any  harsh  .sound 
additional  to  the  normal  blowing  noise  of  hurried  breathing  is 
easily  noted. 

The  finger  placed  on  the  larynx  detects  the  strong  vibratory 
tremor,  and  Friedberger  notes  that  the  left  arytenoid  is  much 
more  easily  displaced  than  the  right,  increasing  the  stridor. 

If  the  horse  is,  at  the  time  of  examination,  the  subject  of  a 
cold,  sore  throat,  or  other  acute  disease  of  the  air  passages  no 
importance  is  to  be  attached  to  any  noise  made  in  breathing,  but 
he  cannot  be  pronounced  a  sound  horse  until,  this  malady  having 
passed  off,  it  is  found  on  careful  examination  that  no  such  sequel 
has  been  left. 

Among  the  most  puzzling  cases  are  those  in  which  the  roaring 
occurs  with  periods  of  intermission.  If  the  horse  has  been  fed 
for  a  short  time  on  vetches  this  may  account  for  its  temporary 
access,  and  unless  the  same  feeding  is  again  allowed  a  recurrence 
is  not  to  be  looked  for.  If  due  to  the  occasional  displacement  of 
a  pedunculated  tumor  of  the  nose  or  pharynx  and  its  interfer- 
ence with  the  action  of  the  larynx  its  existence  may  be  recognized 
by  careful  examination,  diminished  current  of  air  through  one 
nostril,  etc.  But  there  remain  some  rare  cases  in  which  there  are 
no  such  appreciable  causes,  and  yet  the  horse  would  be  pro- 
nounced sotind  or  unsound  as  examined  at  certain  intervals.  On 
this  subject  more  information  is  desirable. 

The  following  varieties  of  roaring  will  be  distinguished  from 
that  of  paralysis  by  the  occurrence  of  the  sound  in  both  acts  of 
breathing  (expiration  and  inspiration)  : — distortions,  tumors  or 
foreign  bodies  in  the  nose  : — tumors  about  the  throat,  in  the  wind- 
pipe or  bronchi  : — distortion  of  the  windpipe,  from  tight  reining, 
fracture  or  congenital  deformity  : — and  the  presence  of  a  false 
membrane  stretching  across  the  windpipe. 


142  Veterinary  Medicine. 

same  or  even  in  a  worse  condition,  the  larynx  meanwhile  un- 
naturall}^  compressed  between  his  narrow  jaws  and  the  nerve 
compressed  or  the  larynx  distorted. 

It  must  be  added,  however,  that  like  some  other  acquired  dis- 
tortions or  alterations  roaring  may  repeat  itself  in  the  progeny. 
Goodwin  mentions  an  instance  of  it  on  the  female  side  through 
three  successive  generations  of  thoroughbreds.  Of  transmission 
on  the  side  of  the  male  the  following  instance  is  noteworthy  : 
M.  Liphaert,  an  extensive  proprietor  in  Livonia,  bought  a  first- 
class  English  thoroughbred  stallion.  His  progeny  were  healthy 
until  he  became  a  roarer  at  ten  years  old.  All  his  foals,  got  after 
this  date,  followed  the  sire  in  becoming  roarers,  and,  it  is  impor- 
tant to  observe,  almost  all  at  the  age  of  ten  years. 

Symptoms.  These,  of  course,  are  manifest  enough  while  the 
animal  is  sufficiently  excited  to  give  rise  to  the  noise.  Certain 
indications  may  be  obtained  even  while  the  animal  stands  in  the 
stable.  If  co2igh  is  excited  by  pinching  the  upper  rings  of  the 
windpipe  it  is  prolonged  into  a  groan.  If  suddenly  threatened 
with  a  cane  the  abrupt  inspiration  which  results  is  attended  by  a 
grtmt.  The  absence  of  these  symptoms  is  not,  however,  suffi- 
cient to  establish  the  non-exi.stence  of  roaring.  The  horse  must 
be  galloped  or  put  to  heavy  draught  to  fully  test  the  breathing 
organs.  Galloping  up  a  steep  hill  is  perhaps  the  best  test.  A 
gallop  over  a  recently  ploughed  field  is  about  equally  good.  Soft 
pasture  land  or  an  unpaved  road  is  preferable  to  Macadam  or 
pavement.  Galloping  in  a  riding  school  on  the  soft  tan  is  an 
excellent  measure  as  the  sound  is  confined  and  the  animal  is 
always  within  earshot  of  the  examiner.  The  person  examining 
should  either  ride  the  horse  himself  or  have  a  disinterested  party, 
in  no  way  connected  with  either  buyer  or  seller,  to  mount  him. 
If  the  rider  is  in  the  interest  of  the  seller  he  may  contrive  to 
slacken  the  pace  before  he  reaches  the  examiner,  or  by  irritating 
the  horse  may  make  it  difficult  to  approach  him  immediately  on 
his  being  pulled  up.  If  in  the  interest  of  the  buyer  he  may  suc- 
ceed, by  the  use  of  a  powerful  bit,  in  drawing  the  horse's  nose  in 
to  the  chest,  or  by  compressing  the  larynx  with  a  tight  throat 
latch  he  may  produce  noise  in  breathing  when  the  animal  is  sud- 
denly brought  to  a  stand.  Unless  the  course  is  up  a  steep  hill  or 
over  a  ploughed  field  the  horse  should  be  galloped  for  from  five 


Dyspnoea  Laryngea.     Roaring.     Hemiplegia  Laryjigea.    143 

to  ten  minutes  ;  lie  should  be  then  made  to  pass  close  to  the  ex- 
aminer at  full  speed,  and  finally  brought  up  suddenly  by  his  side 
and  without  any  previous  slacking  of  his  pace.  The  ear  should 
be  at  once  placed  close  to  the  nostrils,  when  the  slightest  abnor- 
mal sound  accompanying  the  inspiratory  act  will  be  at  once 
recognized. 

Draught  horses  are  sufficiently  tested  by  driving  them  in  a 
heavy  vehicle  or  one  with  the  wheels  dragged.  By  walking 
alongside  or  keeping  the  ear  near  to  the  nostrils  any  harsh  sound 
additional  to  the  normal  blowing  noise  of  hurried  breathing  is 
easily  noted. 

The  finger  placed  on  the  larynx  detects  the  strong  vibratory 
tremor,  and  Friedberger  notes  that  the  left  arytenoid  is  much 
more  easily  displaced  than  the  right,  increasing  the  stridor. 

If  the  horse  is,  at  the  time  of  examination,  the  subject  of  a 
cold,  sore  throat,  or  other  acute  disease  of  the  air  passages  no 
importance  is  to  be  attached  to  any  noise  made  in  breathing,  but 
he  cannot  hz  pronounced  a  soimd  \\oxsq.  until,  this  malady  having 
passed  off,  it  is  found  on  careful  examination  that  no  such  sequel 
has  been  left. 

Among  the  most  puzzling  cases  are  those  in  which  the  roaring 
occurs  with  periods  of  intermission.  If  the  horse  has  been  fed 
for  a  short  time  on  vetches  this  may  account  for  its  temporary 
access,  and  unless  the  same  feeding  is  again  allowed  a  recurrence 
is  not  to  be  looked  for.  If  due  to  the  occasional  displacement  of 
a  pedunculated  tumor  of  the  nose  or  pharynx  and  its  interfer- 
ence with  the  action  of  the  larynx  its  existence  may  be  recognized 
by  careful  examination,  diminished  current  of  air  through  one 
nostril,  etc.  But  there  remain  some  rare  cases  in  which  there  are 
no  such  appreciable  causes,  and  yet  the  horse  would  be  pro- 
nounced sound  or  unsound  as  examined  at  certain  intervals.  On 
this  subject  more  information  is  desirable. 

The  following  varieties  of  roaring  will  be  distinguished  from 
that  of  paralysis  by  the  occurrence  of  the  sound  in  both  acts  of 
breathing  (expiration  and  inspiration)  : — distortions,  tumors  or 
foreign  bodies  in  the  nose  : — tumors  about  the  throat,  in  the  wind- 
pipe or  bronchi : — distortion  of  the  windpipe,  from  tight  reining, 
fracture  or  congenital  deformity  : — and  the  presence  of  a  false 
membrane  stretching  across  the  windpipe. 


144  Veterinary  Medicine. 

Examination  by  manipulation,  auscultation  and  percussion 
along  the  whole  length  of  the  air  passages  alike  during  rest  and 
after  exercise,  may  enable  one  in  unusual  cases  to  recognize  the 
structural  changes  that  give  rise  to  roaring. 

Treatment.  This  has  long  been  considered  as  hopeless,  yet  pre- 
servative and  palliative  measures  are  usually  accessible,  whilst  even 
cures  can  be  effected  in  certain  conditions. 

Preventive  treatment.  First  may  be  noticed  the  rejection  for 
breeding  purposes  of  all  animals  possessing  those  conformations 
of  head,  neck  and  chest  already  referred  to  as  conducing  to  di- 
sease of  the  air  passages  or  distortion  of  the  larynx  or  windpipe. 
Equally  ought  all  roarers  to  be  set  aside  unless  the  exciting  cause 
is  accidental  such  as  fractures  of  the  nasal  bones,  of  the  trachea, 
the  existence  of  polypi,  etc.  Stallions  that  make  a  harsh  noise  in 
breathing  from  an  accumulation  of  fat  about  the  throat  are  not 
necessarily  objectionable. 

The  employment  of  the  bearing  rein  so  as  to  compress  and  dis- 
tort the  larynx  is  to  be  avoided.  If  bearing  reins  are  used  in 
horses  having  short  thick  necks  and  badly  set  on  heads  and 
especially  with  intermaxillary  narrowness  they  should  be  passed 
through  rings  in  the  cheek  piece  of  the  bridle  or  between  the  ears 
and  over  the  forehead  (overdraw  check)  so  that  while  the  head  is 
elevated  the  nose  may  be  projected  forward  after  the  Russian 
fashion  of  equitation.  This  measure  has  indeed  appeared  to  cure 
several  cases  of  roaring.  I  have  met  with  fewer  roarers  in  the 
same  number  of  horses  in  America  than  in  England,  and  this  1 
attribute  to  the  better  mode  of  using  the  bearing  rein  on  this  side 
of  the  Atlantic. 

The  Chick  Vetch  ( Lathy rus  Cicera)  should  be  excluded  from 
the  fodder  of  horses  or  used  in  small  proportion  only.  In  man  it 
is  found  to  be  injurious  when  it  forms  a  twelfth  part  of  the  bread 
used  and  gives  rise  to  paralysis  if  it  amounts  to  a  third  (Aitken). 

Paliative  and  Curative  treatment.  Medicinal  treatment  will 
prove  useless  in  the  great  majority  of  cases  :  as  for  example  in 
paralysis  and  degeneration  of  the  muscles,  in  ossifications,  frac- 
tures, or  distortions  of  the  cartilages,  etc. ,  etc.  Nevertheless  where 
there  is  merely  thickening  of  the  membrane  of  the  larynx  altera- 
tive and  tonic  treatment  may  be  successful  especially  if  associated 
with  iodine  ointment  or  active  blisters  applied  to  the  throat.     A 


Dyspncca  Laryngea.     Roaring.     Hemiplegia  Laryngca.     145 

case  is  reported  by  Diipuy  in  which  a  course  of  arsenic  cured.  In 
Ihese  cases  as  well  as  in  those  due  to  ulceration  of  the  membrane 
the  application  of  caustic  by  means  of  a  staff  and  sponge  as  ad- 
vised in  laryngitis  may  prove  beneficial.  In  .some  cases  of  this 
kind  the  application  of  the  firing  iron  to  the  region  of  the  larynx 
has  an  excellent  effect.     Setons  have  proved  useful  in  some  cases. 

In  cases  due  to  tumors  or  enlarged  glands  pressing  on  the  air 
passages  the  internal  u.se  of  iodine  and  other  alteratives  and  di- 
uretics, and  the  local  applications  of  iodine,  or  mercurial  ointments 
or  of  blisters  have  been  successful.  Failing  in  this  the  tumors 
may  be  removed  with  the  knife  when  accessible. 

If  by  auscultation  the  existence  and  position  of  a  band  of  lymph 
can  be  made  out,  tracheotomy  may  be  performed  and  the  band  ex- 
cised. Percivall  with  reason  doubts  the  possibility  of  the  diag- 
nosis. 

In  cases  due  to  distortion  of  the  larynx  from  tight  reining  the 
bearing  reins  should  be  dispensed  with  or  rearranged  so  as  to  en- 
courage protrusion  of  the  nose,  and  the  horse  should  be  bitted  to 
the  side  chains  or  straps  in  the  stall  several  hours  daily  so  that 
the  head  shall  be  elevated  and  the  nose  protruded. 

When  roaring  depends  on  paralysis  of  the  laryngeal  muscles,  a 
mode  of  palliation  may  be  adopted  as  practised  by  the  London 
omnibus  and  cab  men.  A  strap  is  fixed  round  the  nose  supported 
by  a  strap  passing  down  the  middle  of  the  face  and  the  cheek 
piece  of  the  bridle  on  each  side  and  buckled  beneath  the  chin. 
On  the  inner  side  of  this  strap  where  it  passes  over  the  false  nos- 
trils is  attached  on  each  side  a  semiovoid  pad  which  presses  on 
the  flap  of  the  nostril  and  regulates  the  entrance  of  air.  The 
principle  on  which  it  acts  will  be  understood  when  we  consider 
that  the  paralyzed  cartilage  is  drawn  into  the  passage  by  the  rush 
of  air  and  that  the  closure  of  the  channel  is  more  complete  and 
the  roaring  more  marked  in  proportion  to  the  force  of  the  current. 
The  pads  by  lessening  and  regulating  the  rush  of  air  into  the  lungs 
thus  leave  the  passage  in  reality  more  open  and  largely  obviate 
the  difficulty  of  breathing  and  the  noise. 

In  extreme  cases  with  the  structural  lesion  in  the  head,  throat, 
or  upper  two-thirds  of  the  neck  relief  may  be  secured  by  trache- 
otomy. 

A  more  radical  operation  is  that  introduced  by  Giinther  for  the 
10 


146  Veterinary  Medicine. 

excision  of  the  left  arytenoid  cartilage.  As  improved  by  Moller 
and  others  this  consists  in  an  incision  through  the  cricoid  cartilage 
and  crico-thyroid  membrane  (or  even  the  first  rings  of  the  trachea) 
and  the  complete  extirpation  of  the  left  arytenoid  cartilage  and 
left  vocal  cord.  The  manipulations  belong  to  surgery.  The  re- 
sult is  satisfactory  in  removing  the  violent  dyspnoea  in  hurried 
breathing  and  in  very  favorable  cases  in  obviating  noise  alto- 
gether. More  commonly  some  stridor  remains  but  not  enough  to 
interfere  with  pace  or  with  heavy  draft.  From  my  personal  ex- 
perience in  performing  the  operation,  I  would  recommend  it  in  all 
cases  in  which  the  obstruction  is  so  great  as  to  interfere  with  the 
use  of  the  horse  on  the  track,  or  road,  or  for  heavy  draught.  But  in 
slight  cas2S,  in  which  the  disease  causes  little  or  no  inconvenience 
beside  the  noise,  I  would  advise  some  less  radical  measure. 

Another  obvious  line  of  treatment  is  by  the  use  of  electricity 
locally  and  of  strychnine  internally.  A  weak  current  kept  up  for 
fifteen  minutes  may  be  sent  from  the  positive  pole  in  the  left  jug- 
ular furrow  to  the  negative  pole  over  the  left  side  of  the  larnyx. 
Strychnia  in  the  dose  of  two  grains  may  be  given  daily  in  the  food 
or  in  half  that  amount  hypodermically  over  the  left  side  of  the 
larnyx.  This  would  be  useful  only  in  the  early  stages  with  little  or 
no  fatty  degeneration  of  the  muscles. 


CEDEMA  GLOTTIDIS 

Diseases  Complicated  by  this.  Seat,  Abundance.  Duration,  Sequels, 
Symptoms,  sudden  dyspncea,  swelling  of  throat,  pits  on  pressure,  differen- 
tiation from  croup.  Treatment,  cold,  ice,  astringents,  scarification,  traclie- 
otomy. 

This  is  usually  a  complication  of  acute  laryngitis,  but  it  may  be 
a  manifestation  of  other  forms  of  locai  disease — tuberculosis, 
glanders,  purpura  haemorrhagica,  pseudo-membranous  inflam- 
mation,— or  it  may  be  a  result  of  a  more  distant  affection,  like  dis- 
eae  of  the  heart,  lungs,  or  kidneys.  As  a  complication  of  local 
.inflammation  it  consists  in  an  excessive  serous  exudation  into  the 
submucosa,  around  the  base  of  the  epiglottis  and  extending  to  the 
whole  larnyx  and  pharnyx.  It  may  thicken  the  parts  by  half  an 
inch,  causing  complete  closure  of  the  glottis.  In  favorable  cases 
it  may  subside  as  rapidly  as  it  rose,  while  in  others  it  may  result 
in  ulceration  or  abscess.  The  infiltration  has  usually  a  clear 
watery  a.spect,  but  is  sometimes  a  dull  red.  When  incised  an 
abundance  of  serum  escapes  mixed  in  certain  cases  with  pus. 

Symptoms.  In  the  course  of  one  of  the  above  named  affections 
there  comes  on  suddenly  extreme  dyspnoea,  with  stertorous 
breathing,  a  suffocative  cough,  and  intense  anxiety.  The  stridor 
is  first  with  inspiration  and  later  with  expiration  as  well.  The 
eyes  are  bloodshot  and  protruding,  the  pulse  small  and  rapid,  the 
movements  uncertain,  and  the  skin  moist  with  sweat.  There  is 
manifest  swelling  of  the  throat  and  manipulation  leaves  the  im- 
print of  the  finger. 

When  symptomatic  of  some  distant  affection  it  is  at  once  slower 
in  its  result  and  more  persistent. 

The  local  pasty  swelling  and  the  absence  of  any  false  mem- 
brane suffice  usually  to  distinguish  it  from  croup  which  it  so 
closely  resembles  in  the  suddenness  of  its  onset,  and  the  violence 
of  its  manifestations. 

The  less  urgent  cases  may  be  treated  b)^  application  of  cold  water 
or  ice  to  the  throat,  and  the  injection  of  solutions  of  chloride  of 
iron  or  alum  into  the  fauces.  Or  the  throat  may  be  painted  with 
tincture  of  iodine  and  rubbed  with  the  palm  to  favor  distribution 
and  absorption  of  the  exudate.  In  dogs  the  mouth  may  be  open- 
ed widely  and  the  dropsical  membrane  pricked  at  intervals  to 
drain  off  the  liquid.  In  the  most  acute  cases  the  prompt  adoption 
of  tracheotomy  is  the  only  means  of  saving  life. 
147 


LARYNGEAL      HYPERESTHESIA.       CONVULSIVE 
COUGH. 

Convulsive  cough  with  visible  lesions — without.  Excitants,  cold  air,  or 
water,  rough  or  dusty  food,  irritant  agents  inhaled  or  swallowed.  Treat- 
ment, hygienic,  nerve  sedative,  expectorant,  tonics,  Muriate  of  ammonia, 
Sulphur  dioxide,  silver  solution,  ferric  chloride,  alum,  derivatives,  elimina- 
tion, aromatic,  dietetic. 

The  chronic  or  paroxysmal  cough  may  often  be  traced  to  the 
presence  of  tumor,  ulcer,  local  inflammation,  or  parasite,  but  in 
some  instances  no  local  trouble  is  recognizable,  the  general  health 
remains  good,  and  yet  the  throat  is  abnormally  sensitive  and  a 
cough  or  fit  of  coughing  may  be  roused  by  pas.sing  into  the  cold 
air  from  a  warm  stable,  by  cold  water  in  drinking,  by  inhaling 
irritant  gas,  by  the  passage  of  rough  or  fibrous  food,  or  by 
handling  the  larnyx.  There  is  undoubtedly  a  hyperaesthesia  of 
the  larnyx  and  the  horse  and  dog  as  being  more  exposed  to  severe 
demands  on  the  physical  and  nervous  systems  are  especially  liable 
to  suffer. 

Treatment  must  be  adapted  to  the  conditions.  Over- work, 
damp  unhealthy  buildings,  and  all  appreciable  health  depressing 
causes  must  be  corrected,  and  a  course  of  iron  and  nux  vomica 
may  be  tried.  Borax,  bromide  of  potassium,  and  extract  of  hyos- 
cyamus,  made  into  an  electuary  with  molasses  or  honey  may  be 
smeared  upon  the  molars  four  or  five  times  a  day.  In  obstinate 
cases  the  inhalation  of  the  fumes  of  burning  salammoniac  or  sul- 
phur, or  the  direct  application  to  the  larnyx  of  dilute  solutions 
of  silver  nitrate,  ferric  chloride,  or  alum  may  benefit.  The  throat 
may  be  blistered  by  cantharides  or  mustard.  Care  should  be 
taken  to  keep  the  functions  of  bowels  and  kidneys  normally  ac- 
tive, to  protect  the  patient  against  cold  and  damp,  and  to  give  nu- 
tritive but  non-stimulating  and  easily  digested  food,  as  for  the  hor.se, 
bran  mashes,  roots,  grass  or  scalded  hay,  and  for  the  dog  pulped 
flesh,  soup  and  mush.  Sometimes  benefit  can  be  obtained  from 
the  vegetable  aromatics  and  stimulants  as  eucalyptol,  tar,  turpen- 
tine, balsams  of  Tolu  and  Peru,  tincture  of  anise,  fennel,  etc. 


148 


INFECTIOUS  DISEASES  OF  THE  THROAT. 

Infectious  throat  diseases.  Parasites,  Ivceclies.  CBstrus  larva.  Chronic 
sore  throat.     Mechanical  removal. 

Infections  are  in  many  respects  the  most  serious  affections  of  this 
region  but  their  consideration  must  be  sought  under  strangles, 
distemper,  diphtheria,  anthrax,  actinomyco.sis,  tuberculosis, 
glanders,  etc. 

PARASITES    OF   THE   THROAT. 

Leeches.  These  taken  in  with  the  water  will  sometimes  fasten 
themselves  on  the  walls  of  the  pharnyx  or  even  on  the  lips  of  the 
larnyx,  producing  cough,  sore  throat,  difficulty  of  swallowing, 
bleeding  from  the  nose  (or  mouth),  or  dyspnoea.  They  are  to  be 
removed  as  recommended  above  under  parasites  of  the  nasal 
chambers. 

CEstrus  Larva..  Bots.  In  horses  and  mules  the  larva  of 
the  oestrus  sometimes  attaches  itself  to  the  mucous  membrane  of  the 
pharynx  or  even  of  the  larynx  producing  chronic  irritation,  cough 
and  even  dyspnoea.  A  chronic  sore  throat  with  nasal  discharge, 
occurring  in  autumn  or  winter,  in  the  absence  of  fever  or  constitu- 
tional disorder  may  be  found  to  depend  on  these  parasites  and  to 
recover  when  these  have  been  removed  bv  the  hand. 


GUTTUROMYCOSIS  OF  SOLIPEDES. 

Aspergillus.  Complications,  ulceration,  lesions  of  adjoining  parts,  food 
in  lungs,  hepatization,  gangrene.  Treatment,  by  incision,  sulphur  dioxide, 
iodine. 

Rivolta  and  Bassi  have  found  in  the  guttural  pouches  of  horses 
and  a  mule,  an  advancing  ulceration  of  the  mucosa  partially  cov- 
ered with  crusts  composed  largely  of  the  mycelium ,  conidia  and 
spores  of  Aspergillus  or  a  closely  allied  fungus.  In  the  mule  the 
ulcer  had  opened  into  the  carotid  artery  causing  a  profuse  epis- 
taxis.  In  the  three  horses  there  was  dysphagia,  and  the  food, 
descending  to  the  lungs,  had  caused  pulmonary  hepatization  and 
gangrene.  The  description  of  the  ulcers  led  Raillet  to  infer  the 
existence  of  glanders  and  that  the  presence  of  the  aspergillus  was 
accidental,  rather  than  a  causative  factor.  In  parallel  cases  the 
opening  of  the  guttural  pouch  and  injection  with  sulphurous  acid 
solution  or  dilute  solution  of  iodine  would  be  appropriate  treat- 
ment. 

149 


DISEASES  OF  THE  CHEST. 

Cough,  its  artificial  production,  precautions,  character  in  different  animals. 
Cough  in  disease,  strong,  full,  ringing,  weak,  short,  broken,  abortive,  dry, 
rasping,  croupy,  small,  husky,  soft,  humid,  rattling,  mucous,  paroxysmal, 
sj^mpathetic,  wheezing,  roaring,  whistling,  grunt,  moan.  Expectoration, 
nasal  in  horse,  also  buccal  in  other  animals.  Morbid  expectoration,  watery, 
viscid,  cloudy,  flocculent,  purulent,  rusty,  cretaceous,  parasitic,  foetid,  vari- 
colored, microbic.  Expired  air,  warm,  cool,  vegetable  odor,  acid,  foetid, 
heavy.  Respiration,  number  in  health,  alteration  in  disease,  rapid,  slow, 
tardy,  short,  catching,  quick,  deep,  labored.  Position,  standing,  lying. 
Pleuritic  breathing,  broken-winded. 

Before  describing  specific  diseases,  it  is  needful  to  consider  the 
methods  of  physical  diagnosis  which  enable  the  practitioner  to 
differentiate  the  diseases  of  the  chest.  Some  of  the  following 
remarks  will  bear  equally  on  diseases  of  the  nose  and  throat  as 
well. 

COUGH. 

The  cough  so  varied  in  health  and  in  disease  deserves  careful 
practical  sttidy.  It  can  usually  be  excited  in  solipedes,  sheep  and 
dogs  by  pinching  the  finst  ring  of  the  windpipe  between  the  thumb 
and  first  two  fingers.  In  oxen  it  is  best  produced  by  compressing 
the  anterior  part  of  the  larynx.  In  old  cattle  it  is  difficult  to  pro- 
duce coughing.  In  no  animal  should  the  attempt  be  made  rudely 
nor  unnecessarily  repeated,  as  it  may  tend  to  excite  or  to  aggravate 
already  existing  sore  throat. 

The  cough  of  the  healthy  horse  is  sharp,  /oiid  and  ri7iging,  often 
repeated  two  or  three  times  and  followed  by  a  snort  (clearing  of 
himself).  It  is  weaker  in  young  horses  and  shorter  and  drier  in 
the  aged. 

The  usual  cough  of  the  ox  is  7veak,  dry,  slightly  hitsky  awd  pro- 
longed. 

That  of  the  sheep,  small,  weak  and  dry. 

That  of  the  dog,  also  weak  and  dry. 

A  strong,  full,  deep,  ringing  cough  is  rarely  heard  in  disease 
except  in  slight  irritation  of  the  larynx.     In  such  cases  the  larynx 
is  tender  and  slight  handling  or  pinching  develops  the  cough. 
150 


Diseases  of  the  Chest.  151 

A  weak  cough  wanting  in  reasonance  and  heard  only  at  a 
short  distance  from  the  horse,  is  usually  associated  with  chronic 
chest  diseases  and  the  last  stages  of  acute  thoracic  inflammations. 

A  short,  broken  or  abortive  cough  is  one  which  appears  to 
be  suddenly  cut  short  and  suppressed,  from  the  pain  it  causes.  It 
is  seen  in  the  early  stages  of  inflammations  of  the  serous  mem- 
branes of  the  chest  or  abdomen,  when  the  quick  rubbing  of  the 
dry  and  inflamed  surfaces  of  these  membranes  on  each  other 
produces  exquisite  pain.  It  chara.terizes  especially  the  debut  of 
pleurisy,  pleuro-pneumonia  and  peritonitis.  This  cough  is  in- 
frequent for  the  same  reason  that  it  is  short. 

A  dry,  loud,  rasping,  or  croupous  cough  is  peculiar  to  the 
early  stages  of  laryngitis,  tracheitis  and  bronchitis,  when  the 
membrane  is  swollen,  tense  and  dry.  It  is  equally  met  with  in 
diphtheritic  and  croupous  affections  implicating  the  larynx. 

A  small,  weak,  dry,  husky  cough  without  any  rasping  is 
characteristic  of  broken  wind  (heaves)  emphysema  of  the  lungs, 
asthma,  or  chronic  bronchitis. 

A  soft,  humid  or  rattling  cough  exists  in  the  advanced  stages 
of  laryngitis,  bronchitis  and  pneumonia  when  the  activity  of  the 
inflammation  has  given  way  and  a  free  exudation  has  taken  place 
from  the  mucous  membrane.  It  is  usually  accompanied  by  a  dis- 
charge, in  solipedes  from  the  nose,  and  in  other  animals  from 
no.se  and  mouth. 

A  soft  cough  with  a  peculiar  gurgling  in  the  larynx  is  some- 
times met  with  in  croup. 

A  paroxysmal  cough  is  one  repeated  five,  ten,  or  twenty  times 
in  rapid  succession.  It  is  common  in  chronic  bronchitis,  early 
heaves,  emphysema,  verminous  bronchitis  and  influenza.  In  such 
cases  it  is  ob.served  chiefly  when  the  subject  is  brought  out  to  the 
cold  air,  when  he  takes  a  drink  of  cold  water,  or  when  he  has 
just  had  some  active  exertion,  or  .some  dusty  or  fibrous  food. 

A  symptomatic  cough  is  one  due  to  diisease  in  some  other 
organs  than  the  respiratory,  and  which  irritates  the  air  passages 
through  nervous  sympathy  (reflex  action).  It  is  commonly 
small,  short  and  dry.  Inflammation  or  other  disease  of  the  liver, 
indigestions  and  intestinal  worms  are  occa.sional  causes  of  symp- 
tomatic cough.  In  the  case  of  worms  it  may  be  loud,  clear  and 
rineinsf. 


152  Veterinary  Medicine. 

OTHER    MORBID   SOUNDS. 

Besides  cough  may  be  noticed  the  wheezing  breathing  charac- 
teristic of  broken  ivind,  chronic  bronchitis  and  asthma,  roaring, 
whistlijig,  etc.,  as  already  described,  and  the  sound  between  a 
moan  and  grunt,  produced  in  pneumonia  especially  in  the  ox. 

EXPECTORATION. 

This  escapes  almost  exclusively  by  the  nose  in  horses,  because 
of  the  length  of  the  soft  palate.  It  may  come  from  the  mouth  of 
other  animals,  especially  when  they  cough.  In  the  ox  the  dis- 
charge from  the  nose  is  rarely  seen  because  of  his  licking  it  out 
with  his  tongue.  Rattles  (rales)  in  the  larynx,  trachea  or 
bronchia,  enable  us  to  ascertain  the  .source  of  such  discharges. 

The  nasal  discharge  in  acute  catarrh,  laryngitis  or  bronchitis, 
is  thin,  clear,  and  sligiitly  viscid,  becoming  thick,  whitish  and 
fiocculent  as  the  disease  advances.  It  is  yellowish,  thick,  floccu- 
lent  and  intermixed  with  .shreds  of  false  membranes  in  diphtheria 
or  in  the  croup  of  young  foals  and  calves.  It  is  clear,  slightl}' 
viscid  and  watery  at  the  onset  of  bronchitis.  At  the  debut  of 
pneumonia  it  is  often  reddish  (rusty).  It  is  bright,  red,  frothy 
and  bloody  in  haemoptysis.  It  is  scanty,  clear,  watery,  and  con- 
taining minute  white  fiocculi  in  pulmonary  en.physema  (broken 
wind).  It  is  white,  thick,  curdy,  and  devoid  of  vLscidit)'  in 
chronic  bronchitis  or  when  a  pulmonary  abscess  is  being  emptied. 
It  is  grayish,  thick  and  fiocculent  in  advanced  pneumonia  in  the 
horse. 

Cows  in  the  advanced  stages  of  pulmonary  tuberculosis  ex- 
pectorate a  yellowish,  sticky  matter  containing  minute  hard 
masses  often  cretaceous.  Calves  and  lambs  suffering  from 
strongyli  in  the  lungs  expel  these  in  little  pellets  in  the  midst  of 
a  thick  white  material. 

The  expectoration  is  fetid,  dark  red  and  grumous  in  gangrene 
of  the  lungs. 

In  pulmonary  tuberculosis  and  glanders  the  expectoration  usu- 
ally contains  the  respective  bacilli. 


Diseases  of  the  CJicst.  153 

CHARACTKR    OF   THE    EXPIRED    AIR. 

The  breath  is  sensibly  warmer  in' excited  breathing,  high  fever, 
.and  acute  bronchitis  and  pneumonia.  It  is  cool  in  most  chronic 
diseases,  in  advanced  consumption  and  hydrothorax.  Its  odor  is 
vegetable  and  acid  in  the  acute  indigestions  of  cattle,  and  fetid  in 
many  chronic  diseases  of  the  air  passages  attended  with  destruc- 
tion of  tissue,  or  the  escape  of  imprisoned  pus,  but  especially 
fetid  in  gangrenous  sore  throat  or  gangrene  of  the  lung. 

MODIFICATION    OF   THE    RESPIRATION. 

The  number  of  respirations  in  a  given  time  may  afford  valuable 
indications  in  the  horse  but  in  the  other  domestic  animals  varia- 
tion in  number  imports  little.  In  the  ox  for  instance,  the  respira- 
tions in  health  may  vary  from  twelve  to  eighty  per  minute, 
according  to  the  heat  of  the  cowhouse,  the  plentitude  of  the 
abdominal  organs  and  other  circumstances.  So  in  the  sheep  and 
dog  slight  causes,  quite  compatible  with  health,  may  cause  the 
breathing  to  become  short,  panting  and  hurried. 

The  young  horse  breathes  ten  to  twelve  times  per  minute,  the 
adult  animal  nine  to  ten.  Any  excitement  accelerates.  A  horse 
walked  a  few  hundred  yards  had  the  respirations  increased  from 
ten  to  twenty-eight  per  minute  ;  after  trotting  five  minutes  they 
numbered  fifty-two  ;  after  galloping  five  minutes  sixty-five. 

Hurried  breathii:g  occurring  independently  of  exercise,  heat 
of  the  atmosphere,  or  distension  of  the  abdomen,  is  indicative  of 
fever,  especially  if  associated  with  rapid  pulse  and  increased  heat 
of  the  body. 

Infrequent  respiration  appears  in  certain  brain  diseases  in  the 
intervals  between  the  more  violent  paroxysms,  also  in  poisoning 
by  opium  and  other  narcotics.  Tardy  or  slow  respirations 
differ  from  those  last  noticed  in  the  act  occupying  a  longer  time. 
In  infrequent  breathing  the  act  may  be  short,  though  there  are 
few  respirations  in  the  minute.  This  is  likewise  seen  in  brain 
diseases  and  sometimes  in  broken  wind.  In  the  last  case  there  is 
double  action  of  the  flank,  each  act  of  expiration  being  effected 
by  two  successive  and  distinct  elevations  of  the  flank. 

Quick  breathing  in  which  the  act  occupies  only  a  short  time  is 
usually  abruptly  cut  off,  the  inspiration  terminating  by  a  catch  or 


154  Veterinary  Medicine. 

jerk.  It  is  significant  of  the  early  stage  of  pleurisy,  and  arises 
from  the  desire  to  avoid  the  pain  attendant  on  the  rubbing  together 
of  the  inflamed  surfaces  during  deep  inspirations.  It  is  further 
seen  in  tetanos,  peritonitis,  perecarditis  and  pleurodynia. 

Deep  breathing  with  great  lifting  of  the  flanks  and  loins  is 
characteristic  of  water  in  the  chest,  and  consequent  inability  to 
inflate  the  lungs. 

Labored  breathing,  which  is  at  once  hurried,  deep,  and  with- 
out intermission,  is  seen  in  severe  laryngitis,  croup,  capillary 
bronchitis,  and  pneumonia,  in  all  cases  alike  from  the  difficulty 
experienced  in  introducing  into  the  lungs  the  requisite  amount  of 
air.  It  is  especially  marked  in  double  pneumonia,  pleuro-pneu- 
monia,  complicated  with  effusion  in  the  chest,  and  in  old  standing 
broken  wind  with  dilatation  of  the  right  heart. 

In  all  such  cases  where  there  is  much  interference  with  the 
aeration  of  blood,  whether  from  obstruction  to  the  circulation  of 
blood  or  a  hindrance  to  the  introduction  of  air,  the  horse  invaria- 
bly stands.  The  fact  that  he  has  lain  down  may  be  taken  as  an 
indication  that  improvement  has  taken  place.  The  peculiarity  is 
due  to  the  sharp  outline  of  the  horse's  sternum  inferiorly  so  that 
in  lying  down  he  is  compelled  to  rest  on  his  side  and  the  whole 
weight  of  the  body  tends  to  compress  the  chest.  In  the  ox, 
sheep,  pig  and  dog,  which  can  rest  on  the  sternum,  breathing 
can  be  carried  on  with  comparative  ease  in  the  recumbent  posi- 
tion, and  these  animals  accordingly  do  not  necessarily  stand 
except  in  very  extensive  and  violent  affections  of  the  chest. 

The  occurrence  of  a  short  inspiration  suddenly  checked  and  a 
prolonged  expiration  characterizes  pleurisy,  the  check  to  the  in- 
spiratory act  being  because  of  the  pain  caused  by  dilating  the 
thorax. 

The  double  lifting  of  the  flank  in  expiration: — the  act  appear- 
ing to  be  performed  by  two  distinct  and  successive  acts  is  one  of 
the  most  prominent  symptoms  of  broken  wind,  but  is  not  peculiar 
to  this  disorder.  In  the  horse  it  exi.sts  in  chronic  bronchitis,  dil- 
atation of  the  right  heart,  old  standing  hydrothorax,  and 
diaphragmatic  hernia.  It  is  further  frequent  in  the  acute  disea.ses 
of  the  chest.  In  oxen  it  accompanies  pulmonarj^  emph3'sema, 
pulmonary  consumption,  dilatation  of  the  heart,  foreign  bodies 
in  the  heart,  and  dropsy  of  the  pericardium. 


Relative  Position  of  the  Lungs ^  Heart  and  Other  Organs.      155 

If  accompanied  by  clear  resonance  over  the  chest,  a  permanent 
wheezing  noise  heard  over  the  ribs,  and  the  small,  weak  wheezy 
cough,  it  indicates  emphysema  (broken  wind).  If  with  strong 
impulse  of  the  heart  against  the  ribs  behind  the  elbows,  venous 
pulse  in  the  jugulars,  and  modification  of  the  second  sound  of  the 
heart,  it  bespeaks  cardiac  dilatation  or  other  heart  disease.  If 
with  paroxysmal  cough,  white  curdy  nasal  discharge  and  harsh 
rasping  sounds  heard  at  the  lower  part  of  the  trachea  or  along  the 
upper  part  of  the  lungs  it  betrays  chronic  bronchitis. 


RELATIVE  POSITION   OF  THE  LUNGS,   HEART   AND 

OTHER  ORGANS  IN  THE  DIFFERENT 

DOMESTIC   ANIMALS. 

Relative  positions  of  thoracic  organs.  Diaphragm,  heart,  lung,  in  horse, 
ox,  sheep,  pig,  dog.     Palpitation. 

The  chest  is  that  portion  of  the  trunk  closed  in  on  each  side  by 
the  ribs,  above  by  the  bones  of  the  back,  below  by  the  breast 
bone,  and  behind  by  the  diaphragm.  It  forms  thus  a  cone  flattened 
from  side  to  side  anteriorly,  and  with  its  base,  represented  by  the 
diaphragm  which  slopes  obliquely  from  above  downward  and  for- 
ward and  bulges  forward  in  the  centre  to  a  greater  or  less  extent 
according  to  the  plenitude  of  the  stomach  and  bowels.  It  results 
from  this  arrangement  of  the  diaphragm  that  a  very  thin  layer  of 
lung  only  reaches  to  the  posterior  part  of  the  chest,  and  that  be- 
neath this  are  solid  and  hollow  abdominal  organs  which  modify 
the  results  of  physical  examination. 

In  the  Horse  the  anterior  third  of  the  chest  is  covered  later- 
ally by  the  bulky  and  muscular  shoulders  so  that  it  cannot  be 
satisfactorily  examined.  In  the  median  line  of  the  chest,  at  a 
point  corresponding  to  the  third,  fourth,  fifth  and  sixth  inter- 
ccstal  spaces,  is  lodged  the  heart.  It  deviates  slightly  to  the 
left  side  below  and  by  virtue  of  a  notch  in  the  lower  border  of  the 
lung  is  enabled  here  to  reach  the  surface  and  its  beats  ma)^  be  felt 
by  the  hand  laid  on  the  side  of  the  chest  just  behind  the  left 
elbow. 


156  Vcterhiary  Medicine. 

In  the  Horse  the  diaphragm  is  attached  by  its  outer  border  to 
the  last  rib,  and  to  the  lower  ends  of  all  the  asternal  ribs,  and  the 
extremity  of  the  breast  bone.  A  thin  layer  of  lung  accordingly 
extends  to  between  the  two  last  ribs  superiorly  and  down  to  near 
the  lower  end  of  the  asternal  ribs.  The  subjacent  abdominal 
organs  are  arranged  as  follows  : — On  the  left  side,  and  counting 
from  below,  the  large  intestines  (double  colon),  the  stomach  and 
spleen  and  a  portion  of  the  left  lobe  of  the  liver  : — on  the  right 
side,  below,  the  large  intestines,  above,  the  liver  and  pancreas. 
Of  these  the  stomach  and  intestines  frequently  contain  gases, 
while  the  liver  by  its  solidity  gives  a  special  solid  character  to  the 
right  posterior  part  of  the  chest.  The  spleen  is  too  deeply  situ- 
ated to  affect  much  the  results  of  a  physical  examination.  The 
greatest  substance  of  lung  is  between  the  upper  and  middle 
thirds  of  the  thorax.  The  anterior  third  is  inaccessible  on 
account  of  the  shoulders,  but  more  than  usual  may  be  reached  by 
raising  the  fore  limb  and  drawing  it  forcibly  forwards.  The 
space  between  the  third  and  seventh  ribs  is  occupied  by  the  solid 
mass  of  the  heart,  which  especially  modifies  the  result  of  physical 
examination  on  the  left  side  where  a  notch  in  the  lung  allows  it 
to  approach  the  surface. 

In  the  ox  the  diaphragm  is  only  attached  to  the  last  rib  for  two 
or  three  inches  at  its  upper  extremity  ;  it  is  fixed  to  the  second  last 
rib  as  far  down  as  about  one-third  of  its  length  ;  thereafter  it  is  at- 
tached in  succession  to  the  middle  third  of  the  third  last,  to  the 
lower  third  of  the  fourth  last,  to  the  lower  ends  of  the  next  two  in 
succession  and  to  the  .sternum.  The  result  is  that  the  lungs  do  not 
extend  so  far  back  relatively  to  the  ribs  as  they  do  in  the  horse. 
They  are  virtually  absent  from  the  last  intercostal  space,  present 
only  in  the  upper  third  of  the  .second  la-st,  in  the  upper  two  thirds 
of  the  third  last  and  reach  the  lower  third  only  in  the  space  be- 
tween the  ninth  and  tenth  ribs.  The  paunch  alone  occupies  the 
space  beneath  the  asternal  ribs  on  the  left  side,  and  the  liver  and 
the  solid  mass  of  the  omasum  and  abomasum  that  beneath  the 
right.  The  shoulders  in  fat  improved  beef  breeds  absolutely  pre- 
vent examination  of  the  anterior  third  of  the  chest,  though  in 
thin  animals  and  dairy  breeds  and  scrubs  more  of  this  may  be  ex- 
posed by  raising  the  fore  limb  than  in  the  horse.  The  heart  cor- 
responding in  position  to  the  third,   fourth  and  fifth  intercostal 


Relative  Position  of  the  Lungs,  Heart  and  Other  Organs.      157 

spaces  is  more  completely  covered  by  lung  tissue  and  does  not 
strike  the  left  side  so  forcibly  as  in  the  horse. 

In  the  sheep  the  lung  extends  to  the  last  intercostal  space, 
nearly  as  far  as  its  lower  end  and  the  heart  is  covered  on  the  left 
side  as  well  as  on  the  right  by  lung  tissue.  The  shoulder  is  very 
moveable  and  unless  in  very  fat  animals  allows  of  an  examination 
of  the  greater  part  of  the  anterior  third  of  the  chest. 

In  the  pig  fat  and  indocility  combine  to  defeat  our  purpose  in 
examination  of  the  chest.  If  these  can  be  obviated  it  is  well  to 
know  that  the  diaphragm  is  attached  to  the  upper  two-thirds  of  the 
last  rib,  and  to  the  next  three  in  front  above  their  lower  third. 

In  the  dog  the  diaphragm  is  attached  to  the  upper  two-thirds  of 
the  last  rib,  to  the  lower  third  of  the  next  and  to  the  lower  ends 
of  the  two  following  and  to  the  breast  bone.  The  shoulders  are  so 
mobile  and  the  breast  bone  so  thin  that  nearly  all  the  chest  may 
be  satisfactorily  examined.  The  heart,  covered  on  both  sides 
by  lung,  lies  nearly  horizontall}'  on  the  breast  bone,  through  which 
'  its  position  and  bulk  may  be  clearly  made  out  by  percussion. 

EXAMINATION  BY  TOUCH. 

Pressure  by  the  fingers  in  the  spaces  between  the  ribs  corres- 
ponding to  the  pleura  will  cause  flinching  and  perhaps  grunting 
in  pleurisy.  The  same  result  will  be  seen  in  pleurodynia.  In 
hepatized  lung  and  pleurisy  with  adhesions  there  is  a  diminished 
sense  of  the  movement  felt  in  the  intercostal  spaces  of  the  part  in 
health. 


PERCUSSION. 

Methods.  Tissues  as  good  and  bad  conductors  of  sound.  Immediate, 
mediate  percussion.  Bilateral  symmetry  and  divergence.  Effect  of  build- 
ing, race,  etc.  Horse,  left  side,  right.  Ox,  leftside,  right.  Effect  of  ist 
and  3d  stomachs,  liver,  etc.  Sheep,  diaphragm,  heart.  Pig,  fat,  lean,  heart. 
Dog,  method.  Birds,  back,  ribs.  In  disease,  increase,  decrease,  absence  of 
resonance,  in  large  area,  in  patches.     Crack  pot  sound. 

This  consists  in  striking  the  walls  of  the  chest  so  as  to  bring  out 
the  resonance  of  the  parts.  In  proportion  as  we  tap  gently  with 
the  tip  of  the  finger  or  strike  forcibly  with  the  closed  fist  will  we 
elicit  the  sounds  from  the  superficial  or  the  deeper  parts  of  the 
lung.  Hence  slight  blows  onl}^  must  be  used  when  the  lung  tis- 
sue is  thin,  to  avoid  bringing  out  the  resonance  from  the  deeper 
seated  organs,  and  both  must  be  resorted  to  when  the  lung  is  thick 
to  ascertain  its  condition  at  the  various  depths.  Where  a  mode- 
rate force  is  requisite  the  four  fingers  and  thumb  of  the  right  hand 
are  brought  together  in  a  line  and  the  weight  of  the  hand  as  moved 
from  the  wrist  is  employed  to  bring  out  the  sound.  The  ribs  be- 
ing hard  convey  sound  best  from  the  deeper  parts,  and  on  them 
percussion  is  usually  made.  Care  should  be  taken  not  to  mistake 
the  lesser  resonance  conveyed  through  the  soft  tissues  of  the  in- 
tercostal spaces  for  an  indication  of  a  diseased  condition.  In  pro- 
portion too  as  the  ribs  are  covered  with  flesh  or  fat,  the  resonance 
will  be  diminished  and  a  stronger  blow  will  be  necessary  to  bring 
out  the  sound  from  the  lungs. 

If  the  blow  is  made  directly  on  the  side  of  the  chest  the  percus- 
sion is  called  immediate  \  if  made  upon  an  elastic  solid  body 
(pleximeter)  laid  on  the  outside  of  the  chest  it  is  mediate.  The 
readiest  and  perhaps  the  best  pleximeter  is  the  middle  finger  of  the 
left  hand  which  is  to  be  applied  flat  upon  the  side  of  the  chest  to 
receive  the  blow  directed  perpendicularly  to  its  surface.  In  fat 
or  fleshy  subjects  it  should  be  pressed  firmly  on  the  surface  so  as 
to  compress  and  condense  the  soft  parts  and  render  them  better 
conductors  of  sound.  Some  use  flat  pieces  of  ivory,  silver,  caouch- 
ouc  but  in  employing  these  the  nails  of  the  right  hand  must  be 
carefully  pared,  lest  by  striking  the  solid  body  they  produce  a 
sound  which  interferes  with  the  true  pulmonary  resonance. 
158 


Percussion.  159 

In  examining  the  chest  the  two  sides  should  be  compared  and  if 
allowance  is  made  for  the  dulness  felt  in  the  lower  half  immedi- 
ately behind  the  left  elbow  caused  by  the  position  of  the  heart, 
and  the  deadness  of  the  sound  on  the  last  few  ribs  on  the  right 
side  where  the  liver  is  situated,  any  further  deviation  from  a  bi- 
lateral symmetry  of  sound  is  indicative  of  disease.  The  general 
resonance  will  be  decreased  by  a  full  stomach  which  prevents  the 
full  inflation  of  the  lungs,  and  it  will  be  increased  if  the  animal 
stands  on  a  wooden  floor  with  an  empty  space  below.  A  short 
statement  of  the  degrees  of  resonance  over  the  different  parts  of 
the  chest  in  the  various  races  of  the  domestic  animals  in  a  state  of 
health  may  prove  useful. 

Horse. — Left  side.  In  the  upper  third  the  resonance  is  full 
behind  the  shoulder.  It  diminishes  from  the  13th  rib  backward 
and  from  the  decreasing  thickness  of  lung  the  blows  should  be- 
come less  and  less  powerful.  In  this  space  forcible  striking  brings 
out  the  drum  like  resonance  of  the  abdominal  organs. 

In  the  middle  third  the  sound  over  the  5th  and  6th  ribs  is  dis- 
tinct but  not  full  ;  it  increases  to  the  nth  rib  and  then  decreases 
to  the  last. 

In  the  lower  third  a  very  slight  resonance  may  be  observed 
over  the  4th  rib.  ;  over  the  5th,  6th,  and  7th,  where  the  heart 
approaches  the  surface  the  sound  is  dead  ;  while  from  this  to  the 
13th  rib  a  slight  resonance  may  be  made  out. 

Right  side.  The  upper  third  resembles  that  on  left  side  from 
the  shoulder  as  far  back  as  the  13th  rib  behind  which  anything 
above  the  gentlest  blows  brings  out  a  drum  like  sound  from  the 
large  intestine  (double  colon)  especially.  This  is  clear  when 
that  is  distended  with  gas. 

In  the  median  third  the  resonance  resembles  that  on  the  left 
side.  In  the  lower  third  it  equally  corresponds  as  far  as  the 
seventh  rib  behind,  which  sound  is  dull  because  of  the  proximity 
of  the  liver. 

Ox. — Left  side.  The  upper  third  is  clear  in  sound  from  the 
eighth  to  the  tenth  ribs,  and  behind  this  by  gentle  tapping  to  the 
second  last  (twelfth).  Forcible  striking,  however,  brings  out  the 
drumlike  sound  of  the  upper  sac  of  the  paunch  which  always 
contains  more  or  less  air. 

The  middle  third  has  a  clear  resonance  as  far  as  the  .seventh 


i6o  Veterinary  Medieine. 

rib  ;  this  diminishes  to  the  ninth,  behind  which  it  is  nsually 
replaced  by  a  dnlhiess  due  to  the  presence  of  food  in  the  anterior 
part  of  the  paunch.  By  drawing  back  the  hmb  percussion  may 
b2  employed  over  the  first  and  second  ribs  as  well. 

Ill  the  lower  third  the  first  two  ribs  can  be  examined  and 
a  clear  sound  should  be  educed.  On  the  fourth,  fifth  and  sixth 
ribs  there  is  a  full  resonance,  the  heart  being  here  covered 
by  lung  tissue,  contrary  to  the  condition  in  the  horse.  From  the 
seventh  the  sound  becomes  duller  and  the  dead  sound  from  the 
food  ill  the  rumen  characterizes  the  lower  fourth  of  the  ninth  rib. 

Right  side.  From  the  shoulder  the  resonance  gradually  de- 
creases in  the  upper  third  to  the  eleventh  rib,  beyond  which  the 
sounds  obtained  are  only  from  abdominal  organs.  In  the  middle 
third  considerable  resonance  is  met  with  over  the  first  and  second 
ribs,  it  is  very  full  and  clear  over  the  fifth,  sixth  and  seventh, 
whence  it  decreases  and  is  quite  lost  behind  the  tenth.  In  the 
lower  third  a  clear  sound  can  be  elicited  over  the  first,  second, 
fourth,  fifth  and  sixth  ribs  ;  this  is  lessened  over  the  seventh  and 
eighth,  and  completely  lost  behind  the  ninth.  Any  but  the 
slightest  blows  over  these  three  last  ribs  brings  out  the  dull,  solid 
sound  from  the  liver. 

A  very  full  paunch  greatly  increases  the  anterior  convexity  of 
the  diaphragm,  and  compresses  the  lungs  into  the  anterior  part  of 
the  chest.  If  the  contents  of  the  rumen  are  solid  the  resulting 
dullness  on  percussion  might  be  mistakenly  supposed  to  indicate 
consolidation  of  the  lung.  This  source  of  error  must  be  care- 
fully guarded  against. 

Sheep.  Percu.ssion  in  the  sheep  differs  from  that  in  the  ox 
chiefly  in  the  following  particulars  :  The  diaphragm  being  at- 
tached to  the  last  rib  as  in  the  horse,  the  diminishing  resonance 
of  the  lung  may  be  traced  as  far  back  as  in  that  animal.  Thus  a 
pulmonary  sound  can  be  obtained  in  the  upper  third  as  far  as  the 
last  intercostal  space,  in  the  middle  as  far  as  the  .second  last,  and 
ill  the  lower  as  far  as  the  fourth  from  the  last.  Over  the  lower 
part  of  the  fifth  and  sixth  ribs  on  the  left  side  the  resonance  is 
remarkably  clear  owing  to  the  great  relative  thickness  of  the 
anterior  lobs  of  the  left  lung  which  here  covers  the  heart. 

Pigs.  In  fat  pigs  the  results  are  almost  negative.  In  lean 
animals  the  middle  third  on  each  side  gives  out  a  clear  resonance 


Percussio7i.  i6i 

behind  the  shoulder  as  far  as  the  seventh  rib,  from  which  it 
diminishes  to  the  second  last  (thirteenth).  The  sound  is  less 
clear  in  the  upper  and  lower  thirds.  On  the  fifth  intercostal 
space  below,  and  on  the  left  side  the  sound  is  dull  owing  to  the 
exposure  of  the  heart  through  a  slight  notch  in  the  lung. 

Dog.  Percussion  is  very  satisfactory  in  this  animal  because  of 
the  amplitude  of  the  chest,  the  thinness  of  its  walls  and  the 
small  bulk  of  the  abdominal  organs.  In  the  upper  and  middle 
thirds  on  both  sides  alike  the  sound  is  clear  and  full  as  far  back 
as  the  seventh  rib,  whence  it  decreases  to  the  last.  In  the  lower 
third  a  distinct  but  moderate  sound  marks  the  first  eight  ribs  and 
is  equally  clear  on  the  right  and  left  sides.  The  thinness  of  the 
lung  in  its  posterior  part  demands  that  percussion  be  effected  by 
the  middle  finger  only,  without  any  movement  of  the  hand. 
Unless  the  dog  is  very  fat,  good  results  may  be  obtained  by  per- 
cussion over  the  first  and  second  ribs,  the  shoulder  blade  and 
breastbone. 

Birds.  In  these  and  especially  in  the  webfooted  (ducks, 
geese,)  the  sternum  is  so  thickly  covered  by  flesh  that  no  result 
can  there  be  obtained.  Beneath  the  wings,  however,  and  upon 
the  back  percussion  through  the  medium  of  a  small  coin  as  a 
plexi meter  and  with  the  middle  finger  alone,  is  valuable.  Be- 
neath the  wing  a  clear  sound  may  be  drawn  out  over  nearly  all 
the  ribs  and  on  the  back  over  a  less  extent  (two  and  a  half  to  four 
inches,  according  to  size). 

PERCUSSION   IN   DISEASE. 

Increase  of  resonance  without  any  perceptible  modification  in 
character  is  usually  partial  and  depends  on  the  increased  disten- 
sion of  the  air  cells  of  one  lung,  or  part  of  a  lung,  to  make  up 
for  the  loss  of  a  part  or  a  whole  lung  through  hepatization  or 
pressure  by  false  membrane  or  from  water  in  the  chest.  If  a  part 
of  a  lung  is  solid  and  impervious  it  gives  a  dull,  dead  sound,  con- 
trasting strongly  with  the  increased  clearness  of  the  remain- 
der. So  with  water  in  the  chest,  the  clearness  of  the  upper 
parts  contrasts  unmistakably  with  the  dullness  of  the  lower.  By 
watching  the  advance  or  retirement  of  these  symptoms  the  solidi- 
fication of  a  lung  and  its  process  of  clearing  up,  and  the  effusion 


1 62  Veterinary  Medicine. 

of  water  in  the  chest  and  its  removal  may  be  equally  traced 
through  all  these  stages. 

If  the  increased  clearness  is  confined  to  the  upper,  lower,  or 
posterior  border  of  one  or  both  lungs,  the  sound  being  natural 
over  all  other  parts,  it  indicates  the  existence  of  emphysema  of 
the  lungs,  a  condition  almost  constant  in  broken-winded  horses. 

If  the  sound  is  drumlike  over  most  of  the  lung  it  is  due  either 
to  extensive  emphysema  or  to  the  presence  of  air  as  well  as  liquid 
in  the  cavity  of  the  chest.  In  the  case  first  noticed  there  will  be 
the  double  action  of  the  flank,  the  weak,  dry,  husky  cough  and 
the  wheezing  breathing  ;  in  the  last  there  will  have  been  the  pre- 
vious attack  of  pleurisy,  and  the  application  of  the  ear  to  the 
chest  will  detect  a  splashing  sound  constant  or  heard  only  at  in- 
tervals or  on  rising.  This  should  be  carefully  distinguished  from 
abdominal  gurgling. 

Diminished  resonance,  noticed  over  an  entire  lung,  may  bi^  due 
to  congestion  or  cedema  of  the  lung,  to  the  formation  of  a  thick 
false  membrane  over  the  inner  surface  of  the  ribs  or  to  a  false 
membrane  enveloping  the  lung  and  preventing  its  due  distension. 
Congestion  will  be  distinguished  by  the  blueness  of  the  mucous 
membranes  and  the  presence  of  a  crepitant  sound  heard  on  auscul- 
tation. Pleurisy  is  known  by  the  tenderness  on  percussion  or  on 
pinching  the  intercostal  spaces,  and  by  the  presence  in  many 
'cases  of  a  friction  sound.  The  sound  may  be  further  lessened  in 
cattle  by  the  deposit  of  tubercle  on  the  inner  side  of  the  ribs,  or 
the  extensive  deposition  of  miliary  tubercle  throughout  the  sub- 
stance of  the  lung. 

Absence  of  resonance,  the  sound  brought  out  by  percussion 
being  similar  to  that  obtained  by  practising  it  over  the  muscular 
masses  of  the  haunch,  is  always  partial.  It  is  due  either  to  he- 
patization or  to  water  in  the  chest.  Hepatization  is  distinguished 
by  its  rarely  affecting  the  lower  thirds  of  both  lungs  at  once,  by 
the  presence  of  a  crepitating  rdle  round  the  margin  of  the  area  of 
dullness,  and  by  the  increased  resonance  and  respirator}'  murmur 
over  the  sound  parts  of  the  same  and  the  opposite  lung.  In  water 
in  the  chest  on  the  other  hand  a  friction  sound  and  much  tender- 
ness precedes  the  dullness  ;  the  tenderness  continues  and  the  dull- 
ness reaches  ths  same  height  on  both  sides  of  the  chest,  in  the 
case  of  the  horse.     In  the  ox,  water  may  exist  on  one  side  of  the 


Peraission.  163 

chest  only,  but  the  tenderness  on  pressure  and  the  absence  of  any 
crepitation  serve  to  distinguish  the  case  from  pneumonia.  In  the 
smaller  animals  the  position  of  the  dulness  may  be  altered  by 
turning  the  patient  on  its  back  as  the  water  always  gravitates  to 
the  lowest  point. 

The  presence  of  exten.sive  deposits  of  tubercle,  of  cretaceous  ma- 
terial in  tubercular  cows  and  sheep,  and  the  presence  of  large 
cysts  in  the  lung  may  give  rise  to  dullness  over  a  circumscribed 
area.  Such  areas  of  dullness  are  usually  multiple  with  sound  lung 
between. 

A  further  modification  known  as  the  cracked  pot  sound  is 
sometimes  heard  in  horses  and  cattle.  It  may  be  aptly  repre- 
sented by  laying  the  palms  of  the  two  hands  together  in  such  a 
way  that  they  meet  all  round  and  leave  an  interval  filled  with  air 
right  in  the  centre.  The  back  of  the  one  hand  is  then  struck 
against  the  knee  when  the  noise  of  the  air  escaping  gives  the 
characteristic  sound.  It  occurs  in  consumption  or  in  the  ad- 
vanced stages  of  inflamed  lungs  when  a  large  tubercle  or  abcess 
has  burst  into  a  bronchial  tube  and  the  resulting  cavity  opens 
into  this  tube  by  a  narrow  orifice. 


AUSCULTATION. 

Mediate  and  immediate  auscultation.  Methods,  quiet,  normal  chest 
sounds,  tubal,  bronchial,  vesicular,  respiratory,  cardiac.  Juvenile  respiratory 
murmur.  Horse,  left  side,  right.  Ox,  left  side,  right.  Accidental  sounds, 
rumbling,  gurgling,  crepitation,  friction.  Sheep,  special  features.  Goat, 
force,  rig,  Dog,  Birds,  morbid  chest  sounds.  Increase,  general,  partial. 
Decrease,  general,  partial.  Absence.  Bronchial  sound  in  excess,  in  improper 
place.  Cavernous,  amphoric,  mucous  sounds.  Rales,  sonorous,  sibilant, 
mucous,  submucous,  crepitant,  subcrepitant.  Creaking,  metallic,  tinkling, 
gurgling,  splashing,  friction.    Timbre  of  Cough.    Palpitation.    Mensuration. 

This  is  a  term  used  in  medicine  to  denote  the  mode  of  exploring 
an  organ  by  applying  the  ear  over  the  region  in  which  it  is  situ- 
ated and  deducing  the  healthy  or  diseased  condition  by  the  sounds 
heard.  First  employed  by  Lsennec  in  human  medicine  it  was 
qttickly  availed  of  for  the  lower  animals  by  Delafond  and  lycblanc. 

Auscultation  is  mediate  or  immediate.  Immediate  Auscul- 
tation is  practised  by  applying  the  ear  directly  upon  the  skin, 
either  bare  or  covered  with  a  handkerchief.  In  Mediate  Aus- 
cultation an  instrument  called  a  stethoscope  is  employed  to  con- 
vey the  sound  from  the  surface  of  the  body  to  the  ear  of  ex- 
aminer. The  common  stethoscope  is  formed  of  soft  wood  (cedar 
or  ebony)  or  of  gutta  percha,  is  from  five  to  seven  inches  long 
and  a  quarter  of  an  inch  in  the  bore.  The  end  applied  on  the 
skin  is  widened  into  a  funnel  three-fourths  of  an  inch  across  at 
the  mouth  ;  the  opposite  end  is  flattened  out  to  appl)'  to  the  ear, 
is  about  two  inches  in  diameter  and  has  a  hole  in  the  centre  to 
convey  the  sound.  A  flexible  stethoscope  is  also  used  either  with 
one  or  two  ear  pieces  and  though  less  convenient  in  general  than 
the  common  variety  possesses  this  advantage  when  the  heart  is 
being  examined  that  it  conveys  the  sound  without  the  impulse  of 
that  organ. 

In  mediate  auscultation  the  ear  should  be  closely  applied  to  the 
surface,  the  right  ear  being  used  for  the  left  side  and  the  left  ear 
for  the  right,  but  a  preference  should  always  be  exercised  in 
favor  of  that  in  which  the  sense  of  hearing  is  most  acute.  If  a 
handkerchief  is  used  a  single  fold  only  must  be  applied,  otherwise 
164 


Auscultation.  165 

the  two  layers  may  rub  on  each  other  and  produce  distracting 
sounds.  In  mediate  auscultation .  the  instrument  should  be  held 
perpendicularly  to  the  surface,  accurately  applied  alike  to  the 
skin  and  the  ear,  and  pressed  firmly  on  the  surface  to  condense 
the  soft  structures  beneath  the  skin  and  render  them  more  con- 
ducting. If  held  by  the  hand  care  must  be  taken  to  avoid  the 
slightest  movement  of  the  fingers  on  the  stethoscope,  and  long 
hairs  should  be  prevented  from  entering  the  tube  as  being  likely 
to  produce  additional  sounds. 

Among  other  points  the  following  must  be  attended  to  in  aus- 
cultation. Avoid  a  position  in  which  the  animal  can  strike  you 
with  its  hind  limbs.  If  necessary  in  irritable  or  ticklish  subjects 
have  one  fore  leg  held  up.  Select  a  quiet  time  and  place,  early 
morning  or  night  is  usually  best.  Endeavor  to  protect  the  pa- 
tient from  the  irritation  of  insects  or  the  examinations  may  be 
fruitless.  Never  auscultate  over  a  contracting  muscle  ;  the  sound 
of  muscular  contraction  will  prevent  a  correct  result.  If  the 
natural  sounds  are  indistinct  increase  them  by  exercise.  The 
smaller  animals  are  examined  with  the  greatest  facility  standing 
upon  a  table  or  held  in  the  upright  posture  with  the  body  resting 
on  the  thighs  or  on  the  hind  feet  only.  Birds  can  be  held  by  the 
wings  which  may  be  raised  and  drawn  inward  towards  the  median 
line  to  expose  the  back  and  sides  of  the  chest. 

HEALTHY    CHEST   SOUNDS. 

In  all  healthy  animals  two  distinct  sounds  are  heard  over  the 
chest : — ^tlie  tubal  or  bronchial  sound,  and  the  vesicular  or 
respiratory  murmur.  The  bronchial  sound  caused  by  the  air 
sucking  through  the  larger  bronchi  is  best  heard  by  applying  the 
ear  to  the  breast  over  the  lower  end  of  the  windpipe  or  to  the  upper 
third  of  the  chest  immediately  behind  the  shoulder.  The  respira- 
tory murmur  is  clear  and  full  in  the  middle  third  of  the  chest  im- 
mediately behind  the  shoulder.  It  is  louder  and  more  prolonged 
in  inspiration  than  in  expiration  and  in  the  right  lung  than  the 
left  especially  in  cattle  and  sheep  in  which  the  former  is  more 
capacious.  It  is  louder  in  young  animals  than  in  old,  hence  the 
name  of  juvenile  respiration  applied  by  I^eblanc.  In  thin  animals 
it  is  better  heard  than  in  fat  ones,  the  chest  walls  being  thinner, 
firmer,  and  more  conducting.     In  animals  of  a  nervous  tempera- 


i66  Veterinaiy  Medicine. 

ment  like  the  English  racer  it  is  more  distinct  than  in  the  Norman, 
Clydesdale  and  other  heavier  breeds.  Deep,  broad  capacious 
chests  emit  a  stronger  sound  than  such  as  are  shallow,  narrow  and 
short.  Exercise,  fear  or  any  excitement  accelerating  the  respira- 
tory act  increases  the  sound.  A  full  stomach ,  certain  narcotics  and 
other  depressing  influences  lessen  it.  Other  things  being  equal 
the  sound  is  lower  in  cattle  and  sheep  than  in  other  domestic 
animals. 

Horse.  The  ear  pressed  strongly  upon  the  breast  where  the 
windpipe  enters  detects  a  strong  blowing  sound  referable  to  the 
lower  end  of  the  trachea  and  the  bronchi.  In  young  foals  a 
respiratory  murmur  is  heard  when  the  stethoscope  is  applied  in 
front  of  the  shoulder,  the  limb  being  meanwhile  drawn  backward. 
A  similar  murmur  may  be  heard,  but  less  distinctly  over  the 
shoulder  blade  at  this  age. 

Left  Side.  Behind  the  shoulder  in  the  tipper  third  of  the  chest 
the  sound  is  loud  and  somewhat  harsh,  the  respiratory  murmur 
being  here  supplemented  by  the  noise  of  the  air  rushing  through 
the  larger  bronchia.  From  the  13th  rib  the  respiratory  sound  is 
alone  heard  and  becomes  weaker  to  the  second  last  (17th). 

In  the  middle  third  the  respiratory  murmur  is  moderately  clear 
from  the  4th  to  the  6th  rib,  it  becomes  louder  and  clearer  to  the 
9th  from  which  its  force  gradually  diminishes  and  is  lost  over  the 
16th.  In  the  lower  third  over  the  4th,  5th,  and  6th  ribs  the  re- 
spiratory sound  is  replaced  by  the  sounds  of  the  heart,  each  beat 
being  distinctly  divided  into  two  sounds,  the  first  dull  and  pro- 
longed, the  second  short  and  quick.  The  respiratory  murmur  is 
heard  over  the  7th  and  8th  ribs,  is  weaker  on  the  9th  and  lost 
over  the  loth.  In  the  middle  and  lower  thirds  but  especially 
towards  the  posterior  part  of  the  chest,  abdominal  sounds  are  often 
heard.  They  consist  chiefly  in  gurgling  or  in  a  noise  like  that 
caused  by  the  air  rushing  into  a  bottle  which  has  been  turned 
upon  its  side  when  full  of  water.  Such  sounds  are  easily  dis- 
tinguishable from  those  occurring  in  a  di.sea.sed  chest  as  they  bear 
no  relation  to  the  rythmical  action  of  breathing. 

Right  Side.  In  the  tipper  ajid  middle  thirds  the  sounds  do  not 
differ  from  tho.se  of  the  left  side.  In  the  lower  third  the  respira- 
tory sound  is  clear  from  the  4th  to  the  7th  ribs  ;  from  this  it  de- 
creases and  is  lost  at  the  loth. 


Ausadtation.  167 

Ox.  In  very  lean  cattle  the  respiratory  murmur  heard  in  front 
of  the  shoulder  and  over  the  scapula  is  more  distinct  than  in  the 
same  region  of  the  horse. 

Leftside.  In  the  upper  third  di  c\e2Lr  respiratory  murmur  is 
heard  over  the  8th,  9th  and  loth  ribs  but  is  lost  about  the  nth. 
In  the  middle  third  the  vesicular  sound  is  feeble  at  the  lower 
margin  of  the  region  and  immediately  behind  the  shoulder  because 
of  the  proximity  of  the  base  of  the  heart.  Towards  the  upper 
margin  it  is  loud  and  harsh  being  complicated  by  the  tubal  soux\di. 
It  is  full  and  clear  over  the  yth  rib  whence  it  decreases  in  force  to 
be  lost  at  the  i  ith  above  and  the  loth  below.  In  the  lower  third 
the  double  heart  beat  is  alone  heard  over  the  lower  part  of  the 
4th  rib,  the  respiratory  murmur  reappears  over  the  5th  and  6th 
whence  it  becomes  weaker  and  is  lost  at  the  lower  and  upper 
margin  of  the  region  respectively  over  the  8th  and  9th  ribs. 

Right  Side.  The  sounds  of  the  upper  //«z>^  simply  repeat  those 
of  the  left  side.  In  the  middle  third  the  chief  difference  is  the 
greater  clearness  and  strength  of  the  respiratory  and  tubal  sounds 
immediately  behind  the  shoulder.  In  the  lower  third  a  moder- 
ately strong  respiratory  murmur  is  rendered  harsh  by  a  tubal 
.sound  due  to  the  proximity  of  the  large  bronchus  going  to  the 
anterior  lobe  of  the  right  lung.  The  respiratory  murmur  con- 
tinues with  diminishing  force  to  be  lost  over  the  8th  and  9th  ribs. 

Accidental  but  healthy  Sounds.  These  are  more  loud  and 
frequent  in  the  ox  than  in  the  horse.  There  is  the  same  irregular 
rumbling  and  gurgling  especially  on  the  posterior  parts  of  the 
chest.  Gurgling  as  from  a  full  bottle  inverted  is  often  clearly 
heard  over  the  last  six  ribs  on  the  left  side,  and  appears  due  to 
the  passage  of  liquids  between  the  paunch  and  honey  comb  bag. 
An  occasional  sound  as  of  water  falling  into  an  empty  barrel  is 
heard  in  the  same  region  in  cases  of  slight  tympany  and  after 
saliva  has  been  swallowed.  Rumbling  sounds  are  chiefly  heard 
over  the  last  ribs  on  the  right  .side  where  the  large  and  small 
intestines  are  situated.  The  superadded  sounds  in  the  ox  are 
those  of  crepitation  ^.wA  friction.  The  crepitatioti  or  fine  crackling 
due  to  a  dryness  of  the  areolar  tissue  under  the  .skin  is  frequently 
present  in  oxen  in  average  health.  A  fine  crepitation  is  also  heard 
on  the  left  side  from  the  bursting  of  myriads  of  minute  bubbles 
of  air  generated  among  the  contents  of  the  paunch  during  the 


1 68  Veterinary  Medicine. 

process  of  digestion.  This  is  especially  marked  after  the  animal 
has  fed  on  green  food  or  potatoes.  A  loud  friction  or  rubbi^ig 
sound,  which  may  be  imitated  by  placing  the  back  of  one  hand 
upon  the  ear  and  rubbing  the  palm  of  the  opposite  hand  upon  it, 
is  likewise  heard  over  the  left  side  after  eating.  It  is  produced  by 
the  movements  of  the  paunch  during  contraction  and  not  being 
synchronous  with  the  respiratory  acts  cannot  be  confounded  with 
the  friction  sounds  of  pleurisy  to  be  hereafter  noticed. 

Sheep.  The  diaphragm  being  attached  to  the  last  rib  as  in  the 
horse  the  respiratory  murmur  may  be  heard  to  the  second  last. 
The  shoulders  being  more  movable  than  in  the  ox  the  anterior 
part  of  the  chest  can  be  more  satisfactorily  examined.  The  vesi- 
cular murmur  is  heard  along  the  whole  lower  third  on  the  left  side 
though  the  heart  sounds  are  superadded  over  the  4th,  5th  and 
6th  ribs.  Crepitation  from  the  subcutaneous  areolar  tis.sue  is 
rarely  heard.  Otherwise  the  sounds  of  the  chest  and  abdomen 
correspond  to  those  of  the  ox. 

Goat.  This  animal  differs  from  the  sheep  mainly  in  the  greater 
force  and  clearness  of  the  respiratory  murmur. 

Pig.  It  seems  ridiculous  to  speak  of  auscultating  the  pig,  yet 
he  is  sometimes  thin  enough  and  quiet  enough  to  permit  of  one 
obtaining  satisfactory  results.  Gentle  treatment  and  scratching 
the  back  and  abdomen  will  often  persuade  him  to  be  temporarily 
quiet  and  docile.  The  vesicular  murmur  is  very  clear  in  the 
middle  third  of  the  chest  on  either  side,  but  diminishes  gradually 
on  the  la.st  six  ribs,  and  disappears  on  the  second  last.  It  is  much 
less  intense  in  the  upper  and  lower  thirds.  In  the  posterior  part 
of  the  chest  rumbling  and  gurgling  abdominal  .sounds  are  frequent. 

Dog.  The  respiratory  murmur  is  very  clear  over  the  whole 
chest.  It  is  most  intense  along  the  middle  third  and  becomes  less 
clear  on  the  4  or  5  last  intercostal  spaces.  The  mobility  of  the 
shoulder  permits  an  examination  of  nearly  the  entire  chest.  The 
respiratory  murmur  may  be  heard  over  the  entire  length  of  the 
lower  third  on  the  left  side  though  the  heart's  sounds  are  equally 
heard  over  the  4tli,  5th  and  6th  ribs.  Rumbling  and  gurgling 
abdominal  sounds  are  much  less  frequent  than  in  herbivora  and 
omnivora. 

Birds.  The  respiratory  murmur  is  loud,  clear  and  almost  harsh 
on  the  sides  of  the  thorax,  beneath  the  wings,  and  considerably 
softer  as  heard  on  the  back. 


Aziscidtation.  169 

MORBID  CHEST  vSOUNDvS. 

The  close  study  of  the  healthy  chest  sounds  upon  the  living 
animal  is  an  essential  prerequisite  to  the  appreciation  of  the 
morbid.  The  abnormal  noises  are  so  varied,  merge  into  each 
other  by  such  imperceptible  degrees,  and  so  coexist  and  complicate 
each  other  that  they  often  prove  extremely  puzzling  to  the  un- 
practised ear.  It  is  no  more  necessary  that  the  musician  should 
educate  his  ear  to  appreciate  the  most  delicate  gradations  of 
musical  notes,  than  that  the  auscultator  should  educate  his  in  the 
sounds  of  the  healthy  and  diseased  chest.  Written  instructions 
are  of  about  equal  value  in  the  two  cases,  they  prove  auxiliaries 
in  the  acquisition  of  knowledge  but  they  can  never  supersede  the 
practical  study  of  the  chest.  A  mere  theoretical  knowledge  is  too 
often  useless  in  the  presence  of  the  patient. 

The  abnormal  chest  sounds  are  either  modifications  of  those 
existing  in  health,  or  superadded  sounds  which  have  no  counter- 
part in  the  healthy  chest. 

Modifications  of  healthy  sounds.  The  vesicular  or  respiratory 
murmur  may  be  increased  or  diminished  in  force  or  it  may  be 
entirely  absent. 

Increase  of  the  respiratory  murmur,  is  merely  an  increase 
in  force  without  any  modification  in  character  and  resembles 
juvenile  respiration.  If  increased  equally  over  the  entire  chest  it 
is  general,  if  only  in  a  part  it  is  partial.  General  increase  of 
the  vesicular  murmur  is  heard  after  an  animal  has  been  sub- 
mitted to  moderate  exertion  for  ten  or  fifteen  minutes.  In  ani- 
mals at  rest  it  is  heard  in  active  fevers  and  in  the  symptomatic 
fever  which  attends  acute  inflammations. 

Partial  increase  as  for  example  in  one  lung  only,  or  in  cir- 
cumscribed parts  of  both  lungs,  and  especially  along  their  superior 
borders,  is  indicative  of  disease  of  the  lungs  or  the  pleurae.  It 
testifies  to  the  impermeability  to  air  of  some  other  portion  of  lung, 
from  congestion,  splenisation ,  hepatisation,  plugging  of  a  bron- 
chial tube  with  tenacious  mucous,  tubercular  deposits,  tumors, 
emphysema,  or  hydrothorax.  (See  under  these  names.)  The 
healthy  portion  of  lung  in  such  cases  takes  on  the  function  of  the 
whole,  and  the  loud  breathing  is  called  supplementary. 

Diminution   of  the  respiratory   murmur,  like  its  increase, 


lyo  Veterinary  Medicine. 

xvi'^Y  hz  partial  or  general.  General  diminution  is  seen  in 
anaemia,  in  low  fevers,  in  all  very  prostrate  conditions  from  the 
mere  want  of  power  to  dilate  the  chest  ;  in  general  emphysema 
(broken  wind,  heaves),  in  general  miliary  tubercular  deposit  in 
the  lungs,  or  in  that  form  in  cattle  in  which  the  tubercle  has  been 
replaced  by  cretaceous  deposits,  from  the  animal's  inability  to 
fully  dilate  the  air  cells  ;  in  enteritis,  peritonitis  and  metritis 
the  chest  is  more  fully  dilated  because  of  the  pain  attendant  on 
that  act,  and  the  breathing  being  short  and  quick  the  murmur  is 
correspondingly  low.  Jn  certain  brain  diseases  with  sluggish 
respiration  the  sound  is  equally  feeble. 

Partial  diminution  of  murmur  is  more  surely  indicative  of 
lung  disease.  It  may  arise  from  partial  congestion  when  a  sup- 
plementary murmur  will  be  observable  over  other  parts  of  the  lungs, 
and  a  crepitant  rale  soon  appears  in  the  congested  part  ;  from 
local  emphysema  in  which  there  is  increased  resonance  in  per- 
cussing the  part  ;  from  tubercular  or  cretaceous  deposit,  wdien 
there  will  be  exaggerated  murmur  elsewhere,  or  from  bronchitis 
with  blocking  up  of  one  or  more  small  bronchial  tubes  and  with 
louder  respiratory  sound  in  other  parts. 

Absence  of  respiratory  murmur  may  be  due  to  various 
causes,  all  of  a  diseased  nature.  Hepatisation  of  lung  may  be 
recognized  when  this  condition  is  found  associated  with  a  crepi- 
tating rale  around  the  margin  of  the  silent  part,  and  when  per- 
cussion .shows  its  solidity  and  want  of  resonance.  Splenisation 
is  a.ssociated  with  absence  of  respiratory  sound  and  dullness  on 
percus.sion,  but  no  surrounding  crepitation.  Absence  of  .sound 
in  water  in  the  chest  is  confined  to  the  lower  part  of  the  chest, 
keeps  the  .same  level  and  ratio  of  increase  in  front  and  behind, 
and  in  the  horse  on  the  two  sides,  and  has  been  preceded  by  the 
characteristic  catching  breathing  and  the  friction  .sounds  of 
pleurisy.  Large  tumors  and  exten.sive  and  circumscribed  tuber- 
cular deposit  will  give  rise  to  absence  of  .sound  over  a  limited  area 
and  plugging  up  of  one  or  more  bronchial  tubes  will  lead  to  a 
similar  result.  Hepatisation  of  lung  and  water  in  the  chest  are, 
however,  the  common  causes  of  loss  of  respiratory  murnuir. 

The  bronchial  or  tubal  sound  may  be  increased  in  pitch  and 
in  harshness  in  two  conditions,  ist.  In  the  early  .stages  of  bron- 
chitis when   the  lining   mucous  membrane  of  the  air  passages  is 


Aiisailtation.  171 

dry,  thickened  and  inelastic.  2d.  When  that  portion  of  lung  in- 
tervening between  one  of  the  larger  tubes  and  the  surface  of  the 
chest  is  solid  (hepatised)  and  thus  proves  a  better  conductor  of 
sound  than  in  the  normal  condition. 

Superadded  abnormal  sounds.  The  bronchial  sounds  may 
be  altered  in  their  character  so  as  to  become  cavernous,  am- 
phoric or  mucous  (ratthng).  The  cavernous  sound  is  usually 
caused  by  the  presence  in  the  lung  of  the  cavity  left  after  the 
discharge  of  an  abscess  or  softened  tubercle  into  a  bronchial 
tube.  It  is  thus  preceded  by  cough  and  white,  creamy  discharge 
from  the  nose.  If  the  discharge  is  fetid  and  grumous  there  has 
probably  been  circumscribed  gangrene  of  the  lung.  An  approxi- 
mation to  the  sound  may  be  produced  by  blowing  into  a  wide- 
mouthed  glass  or  porcelain  vessel.  The  sound  of  amphoric 
respiration  on  the  contrary  is  like  that  made.by  blowing  into  a 
narrow-necked  bottle.  It  is  due  to  a  similar  cavity  with  a  small 
orifice  or  to  the  existence  of  pneumo-thorax  communicating  by  a 
narrow  canal  with  a  bronchial  tube.  It  is  rare  in  the  lower  ani- 
mals, but  Delafond  mentions  one  case  in  the  horse  and  two  in 
dogs. 

Rales.  The  remaining  morbid  sounds  are  known  as  rciIes,  or 
rattles.  They  may  either  be  referable  to  the  bronchial  tubes  or 
the  lung  tissue.  They  are  called  dry  or  humid,  according  as 
they  convey  the  idea  of  air  drawn  through  a  dry  tube  or  one 
containing  liquid. 

The  dry  rales  are  due  to  narrowing  of  the  bronchial  tubes 
from  the  pressure  of  adjacent  tumors,  the  thickening  of  the 
mucous  membrane  or  the  deposition  on  the  surface  of  layers 
of  tenacious  mucus.  The  greater  the  narrowing  the  shriller  the 
sound,  and  hence  the  distinction  of  bronchial  rales  into  sonorous 
and  sibilant  (whistling). 

The  sonorous  rale  has  been  variously  exemplified  by  the  hum- 
ming of  a  gnat,  the  cooing  of  a  wood  pigeon  or  the  bass  notes  of 
a  violin.  It  commonly  bespeaks  the  onset  of  bronchitis  and  tes- 
tifies to  the  thickened,  dry  and  rigid  character  of  the  tubes,  but 
may  give  place  in  as  short  a  time  as  three  hours  to  a  mucous  rale 
from  the  occurrence  of  a  free  secretion.  It  rarely  extends  over 
two  or  three  days.  Sometimes  when  caused  by  a  piece  of  tena- 
cious mucus  obstructing  a  tube,  it  is  very  transient  disappearing 


172  Veterinary  Medichie. 

at  once  when  the  mucus  is  expelled  by  coughing.  Sometimes  it 
is  modified  by  an  occasional  clicking  sound  from  the  flapping  of 
a  shred  of  semi-solid  mucus  attached  to  the  walls  of  a  bronchial 
tube.     This  disappears  when  breathing  becomes  more  hurried. 

The  sibilant  (whistling;  rale  often  acknowledges  the  same 
causes  as  the  sonorous,  but  indicates  a  narrower  closure  of  the 
tubes.  More  frequently  it  is  heard  further  back  on  the  chest  and 
results  from  pulmonary  emphysema  and  dilatation  of  the  smaller 
bronchial  tubes  (broken  wind,  heaves).  It  is  then  heard  chiefly 
in  expiration  and  coincidently  with  the  second  quick  lifting  of  the 
flank.  It  is  further  associated  with  the  double  lifting  of  the 
flank  in  expiration  with  the  short,  weak,  paroxysmal  cough  and 
the  indigestion  characteristic  of  broken  wind.  If  the  whistling 
noise  is  so  loud  as  to  be  heard  without  applying  the  ear  to  the 
chest  it  is  called  wheezing. 

A  mucous  rale  is  caused  by  air  passing  through  any  liquid 
contained  in  the  bronchial  tubes,  such  as  mucus,  pus,  or  blood.  It 
may  be  imitated  by  blowing  a  large  number  of  soap  bubbles  in  a 
thick  lather  and  noticing  them  burst  simultaneously  or  successive- 
\y.  It  is  chiefly  observed  in  bronchitis  after  the  preliminary  dry 
stage  of  the  mucous  membrane  has  passed  off  and  an  abundance  of 
mucus  has  been  secreted.  The  nature  of  the  sound  will  vary  ac- 
cording as  it  conies  from  the  larger  or  the  smaller  tubes  or  in  other 
words  as  to  whether  the  bubbles  are  large  or  small.  That  from 
the  smaller  tubes  is  sometimes  called  a  submucous  rale.  Either 
of  these  rales  may  be  temporarj^  or  permanent  as  the  mucus  may- 
be momentarily  cleared  away  by  coughing. 

The  crepitant  rale  is  a  sound  of  very  fine  crackling  which  has 
been  variously  compared  to  the  crackling  of  salt  when  put  on  red 
hot  coals,  the  noise  of  a  sponge  expanding  in  water  and  the  rub- 
bing of  a  small  lock  of  hair  between  the  finger  and  thumb  close  to 
the  ear.  The  existence  of  the  crepitant  rale  usually  denotes  the 
existence  of  the  early  stage  of  inflammation  of  the  lungs,  and  the 
progress  of  hepatization  in  such  cases  may  be  traced  by  the  ad- 
vance of  the  line  of  crepitation  which  precedes  it.  So  the  progres- 
sive absorption  of  exuded  matter  in  recovery  may  be  equally  fol- 
lowed by  a  line  of  crepitation  gradually  decreasing  in  area  until  it 
meets  in  a  point.  The  observations  will  be  coroborated  by  the 
dull  sound  elicited  on  percussing  the  parts.     The  production  of 


Ausadtation.  173 

the  sound  has  been  attributed  to  the  passage  of  air  through  the 
thick  mucus  in  the  smallest  bronchial  tubes  or  more  plausibly  to 
the  separation  of  the  walls  of  the  air  sacs  and  cells  during  inspir- 
ation, they  having  been  previously  adherent  by  reason  of  the  se- 
cretions. 

Crepitation  is  not  heard  in  all  pulmonary  inflammations.  In 
weak  animals  with  a  low  type  of  inflammation  tending  to  gangrene, 
and  in  those  cases  of  broncho-pneumonia  in  which  a  viscid  mucus 
blocks  up  the  bronchial  tubes  passing  to  the  affected  lobes,  it  may 
be  altogether  absent. 

Crepitation  may  further  occur  without  inflammation.  Thus  in 
pulmonary  oedema  (dropsy  of  the  lung)  and  capillary  hemorrhage 
in  which  liquids  are  effused  in  the  smaller  bronchial  tubes  and  air 
sacs  a  crepitation  is  sometimes  heard. 

A  modified  crepitation  (dry  crepitant  rale  of  Delafond)  is 
usually  heard  over  an  emphysematous  lung.  The  noise  in  this 
case  has  been  compared  to  that  induced  by  handhng  a  sheet  of 
paper. 

The  subcrepitant  rale  is  another  modification  holding  a  place 
intermediate  between  the  crepitant  and  the  mucous  rales.  It  has 
been  likened  to  the  sound  of  a  moderate  effervesence  in  beer  or  other 
liquid.  It  is  referable  to  the  presence  of  mucus  in  the  smaller 
bronchial  tubes  and  indicates  bronchitis  or  broncho-pneumonia. 

Still  other  sounds  are  heard  in  diseased  conditions  of  the  pleurae. 
These  are  friction  sound,  creaking,  metallic  tinkling,  and 
gurgling  or  splashing. 

A  friction  sound  is  heard  in  the  early  stages  of  pleurisy  and  is 
caused  by  the  dryness  of  the  pleural  surfaces  from  the  absence  of 
the  halitus  or  vapor  which  normally  moistens  them  and  the  depo- 
.sition  of  layers  of  lymph  by  which  the  surfaces  are  rendered  rough 
and  uneven.  An  approximate  sound  may  be  observed  by  placing 
the  palm  of  the  left  hand  on  the  right  ear  and  drawing  a  finger 
of  the  right  softly  over  its  back.  The  sound  is  quick  and  jerking, 
one  or  a  few  jerks  only  being  heard  with  each  inspiration  as  the 
act  is  cut  short  on  account  of  the  pain  attending  the  friction.  It 
is  rarely  heard  in  expiration.  It  is  chiefly  heard  at  the  lowest 
part  of  the  chest  where  the  lungs  have  the  greatest  freedom  of 
movement.  The  thinness  of  the  walls  of  the  chest  above  the  breast 
bone  in  cattle  and  dogs  permits  the  friction  sound  to  be  heard  more 


174  Veterinary  Medirme. 

distinctly  than  in  the  horse.  After  the  lapse  of  twelve,  twenty- 
four  or  forty-eight  hours  the  friction  sound  disappears,  the  sur- 
faces of  the  pleurae  being  separated  by  the  liquid  effusion,  but  it 
may  reappear  when  the  fluid  is  absorbed  in  the  process  of  recov- 
ery. Sometimes  the  friction  is  further  manifested  by  vibration 
of  the  walls  of  the  chest  perceptible  to  the  touch. 

The  creaking  sound,  as  from  the  bending  of  a  piece  of  strong 
leather  is  caused  by  the  movement  of  a  thick  and  solid  false  mem- 
brane binding  the  lungs  to  the  side  of  the  chest.  This  is  often 
confounded  with  crepitation. 

Metallic  tinkling  is  only  heard  when  liquid  and  gas  both  exist 
in  the  pleural  sac  and  is  due  to  the  falling  of  a  drop  from  the 
shreds  of  false  membrane  above  into  the  fluid  contents  below. 
The  sound  is  somewhat  like  the  falling  of  drops  in  a  closed  cask 
half  full  of  water,  or  it  may  be  fairly  exemplified  by  placing  the 
palm  of  the  left  hand  flat  on  the  right  ear  and  striking  the  back 
of  the  hand  smartly  with  the  middle  finger  of  the  right.  The 
sound  is  chiefly  heard  after  the  patient  has  changed  its  position 
and  especially  after  rising.  The  explanation  of  this  is  that  in  the 
recumbent  position  the  liquid  changes  its  place  and  bathes  parts 
which  in  standing  are  surrounded  by  gaseous  products  only. 
Drops  accordingly  fall  into  the  liquid  for  some  time  with  dimin- 
ishing rapidity  until  they  cease  altogether.  Other  explanations 
of  the  sound  but  which  less  frequently  exist  are  :  the  ascent  of  a 
bubble  through  the  liquid  and  its  bursting  on  the  surface  ;  and 
the  sudden  recoil  of  air  from  one  wall  of  the  plueral  cavity  to  the 
other  as  the  result  of  movement  or  sound  generated  in  the  deeper 
seated  solid  structures. 

A  gurgling  or  splashing  sound  is  equally  indicative  of  the 
presence  of  fluid  and  gas  in  the  pleural  sac.  It  is  almost  never 
heard  unless  after  a  sudden  movement  on  the  part  of  the  patient 
causing  considerable  commotion  in  the  contained  liquid.  Gur- 
gling sounds  transmitted  from  the  abdomen  are  too  often  mistaken 
for  this.  In  small  animals  wath  liydro-pneumo-thorax  a  quick 
shaking  of  the  patient  will  develop  it. 

Auscultation  of  the  Cough  is  sometimes  valuable,  though 
more  difficult  and  less  satisfactory  in  the  lower  animals  than  in 
man,  chiefly  because  of  the  extensive  movement  of  the  ribs  in  the 
former.     As  conveyed  through  a  healthy  lung  to  the  ear  applied 


Auscultation.  175 

on  the  side  of  the  chest,  the  sound  is  short,  dull  and  indistinct. 
When  the  lung  is  more  solid  from  hepatisation,  pleural  exudation 
or  other  cause,  or  when  the  bronchi  are  dilated  the  sound  is  loud 
and  strong.  The  extent  over  which  it  may  be  heard  thus  forcibl}- 
agrees  w^ith  the  area  of  lung  in  a  state  of  consolidation.  When  a 
considerable  cavity  or  canal  communicates  with  a  bronchial  tube 
and  extends  to  near  the  surface  of  the  lung  the  sound  is  loud  and 
rmging.  The  note  is  specially  clear  and  metallic  when  such  a 
cavity  opens  into  the  bronchus  by  a  narrow  orifice  ;  an  apt  illus- 
tration of  this  noise  may  be  obtained  by  coughing  into  a  narrow 
necked  vessel. 

The  results  obtained  by  auscultation  should  be  confirmed  by 
percussion  before  arriving  at  any  definite  conclusion  as  to  the  state 
of  the  chest.  Consolidated  lung  tissue  is  a  much  better  conductor 
of  sound  than  the  healthy,  and  sounds  conveyed  through  this  may 
be  heard  at  a  considerable  distance  from  their  point  of  origin. 
Thus  the  heart  sounds  are  frequently  heard  over  any  part  of  the 
right  side  of  the  chest,  and  crepitation  and  other  sounds  may  be 
heard  in  the  centre  of  a  hepatized  portion.  On  all  such  occasions 
the  dull  sound  elicited  on  percussion  will  not  fail  to  correct  the 
fallacy. 

PALPATION.       TOUCH. 

This  is  chiefly  useful  in  cases  of  pleurisy.  As  already  noticed 
the  vibration  of  the  chest  walls  which  accompanies  the  early  fric- 
tion sound  is  sometimes  perceptible  by  the  hand  applied  on  the 
side  of  the  chest.  Pressing  firmly  in  the  intercostal  spaces  at  the 
affected  part  invariably  causes  wincing  and  in  cattle  grunting. 
Pinching  the  back  in  inflammatory  chest  diseases  in  cattle  but 
e.specially  in  pleurisy  has  a  similar  effect. 

MENSURATION. 

Measurement  of  the  chest  gives  less  reliable  results  in  the  lower 
animals  than  in  man.  A  cord  four  feet  long  should  have  one  end 
placed  on  a  definite  point  on  the  withers  and  not  removed  until 
both  sides  have  been  examined.  It  should  be  first  carried  down 
to  a  point  in  the  middle  of  the  breast  bone  and  the  distance 
marked  by  a  knot ;  a  comparison  may  be  made  by  carrying  to  the 
same  point  over  the  opposite  side.     It  should  next  be  carried  sue- 


176  Vetcrbiary  Medicine. 

cessively  to  the  lower  end  of  the  Sth  rib  on  the  two  sides  and  the 
difference  marked,  and  lastly  from  the  lower  end  of  the  third  rib 
to  the  lower  end  of  the  eighth.  These  measurements  should  be 
made  at  one  stage  of  the  respiratory  act,  say  when  the  chest  is 
fully  dilated,  and  similar  measurements  when  the  chest  is  collapsed 
to  ascertain  any  difference  in  the  expansion  of  the  two  sides  of 
the  chest.  In  the  smaller  animals  any  difference  in  the  expansion 
of  the  two  sides  may  be  observed  by  inspection  only,  the  practi- 
tioner standing  directly  behind  the  animal  and  watching  the 
movements  of  the  two  sides  from  this  standpoint. 

A  permanent  dilatation  of  one  side  may  be  seen  in  water  in  the 
chest  confined  to  one  side,  and  particularly  if  of  some  standing. 
Complete  hepatisation  of  one  lung  gives  a  similar  result.  The 
intercostal  spaces  are  observed  to  be  wider  than  usual  in  such 
cases,  and  the  movements  of  the  opposite  side  of  the  chest  are 
much  more  extensive  than  of  the  affected  one. 

A  collapse  with  limited  movement  of  one  side  is  an  accompani- 
ment of  chronic  disease  of  the  lung,  with  wasting  of  its  substance 
as  in  cases  of  tubercular  deposit. 


DISEASES  OF  THE  I.UNGS. 

Divisions  of  liitig  diseases.  Bronchitis,  pneumonia,  pleurisy,  their  re- 
sults, nervous  disorders,  asthma,  hiccough.  CEdema.  Emphysema.  Mor- 
bid growths,  neoplasms.     Infectious  and  parasitic  diseases. 

Inflammatory  diseases  of  the  respiratory  organs  situated  within 
the  chest  may  be  divided  into  :  inflammation  of  the  air  tubes 
within  the  substance  of  the  lungs — bronchitis  : — inflammation  of 
the  spongy  tissue  of  the  lung — pneumo7iia  . — inflammation  of  the 
covering  of  the  lungs  and  lining  serous  membrane  of  the  chest — 
pleurisy . — and  complicated  cases  in  which  two  or  more  of  these 
conditions  coexist.  Beside  inflammatory  diseases  there  are  the 
various  permanent  morbid  results  of  these  affections,  such  as  con- 
solidation of  lung  from  exuded  products  becoming  organized  ; 
collapse  (compression)  of  lung  from  organization  and  contraction 
of  false  membranes,  thickening  or  dilatation  of  bronchial  tubes 
as  a  result  of  bronchitis  ;  also  nervous  affections,  such  as  asthma 
and  hiccough  ;  morbid  alterations  in  the  lung  tissue  independently 
of  inflammation,  as  pulmonary  or  pleural  oedema  and  emphy- 
sema ;  specific  morbid  deposits,  as  tubercles,  glander  nodes, 
cancer,  melanosis,  etc.,  and  morbid  states,  due  to  parasites,  as 
in  the  verminous  affections  of  cattle,  sheep,  etc. 


177 


BRONCHITIS. 

Relation  to  other  maladies  of  the  air-passages.  Horse.  Causes,  suscepti- 
bility, heat,  cold,  sudden  changes,  thick  coat,  rebreathed  air,  on  shipboard, 
in  zoological  gardens,  in  close  stables,  in  navies,  organic  matter  in  expired 
air,  water  vapor  in  expired  air,  effect  on  the  air  and  bacteria.  Ingesta  in 
bronchia.  Medicinal  liquids  in  bronchia  in  horses  and  cattle.  Exposed 
locations.  Clipping.  Smoke  and  gaseous  irritants.  vSymptoms,  in  mild 
cases,  in  severe  :  fever,  cough  in  dry  stage,  after  secretion,  auscultatory 
sounds,  percussion,  discharge,  vpatery,  glairy,  frothy,  later  milky,  flocculent, 
purulent.  Convalescence.  Capillary  and  pseudomembranous  form.  Intensity 
of  symptoms,  labored  breathing,  dyspnoea,  violent  cough,  pinched  counte- 
nance, dark  mucosae,  perspirations,  palpitations,  asphyxia.  Course,  du- 
ration. Termination,  difficult  expectoration,  blocking  of  bronchia,  pneu- 
monia, bowel  susceptibility,  skin  congestion,  laminitis.  Chronic  condition. 
Lesions,  congestion  and  contents  of  bronchia,  soft,  thick,  friable  mucosa, 
absence  of  vascular  ramification,  tenacious  mucus,  false  membranes.  Col- 
lapse, atelectasis,  spleuisation,  emphysema,  bronchiectasis.  Treatment, 
in  mild  cases,  in  severe,  hygienic,  steaming,  sulphur  dioxide,  derivatives, 
guarded  laxative,  neutral  salts,  calmatives,  expectorants,  alkalies,  stimu- 
lant, oxygen,  peroxide  of  hydrogen,  iodide  of  potassium.  Diet.  In  ad- 
vanced stages  tonics. 

Defi7iition.  Inflammation  of  the  mucous  membrane  which  lines 
the  bronchia.  It  is  the  counterpart  of  coryza  and  laryngitis,  be- 
ing but  the  inflammation  of  another  portion  of  the  same  mucous 
membrane  which  hues  the  whole  respiratory  track.  That  portion  of 
this  mucous  membrane  which  lines  the  trachea  is  rarely  or  never 
the  exclusive  .seat  of  inflammation,  so  that  in  case  of  its  being 
implicated  we  do  not  speak  of  the  case  as  one  of  tracheitis  but  as 
lary7igitis  or  bronchitis,  according  as  the  throat  or  bronchia  form 
the  seat  of  active  inflammatory  action. 

The  bronchial  mucous  membrane  is  often  inflamed  in  influenza, 
strangles,  contagious  pleuro-pneumonia  of  cattle,  distemper  in 
dogs,  and  parasitic  diseases  of  the  lungs,  but  the  following  re- 
marks will  be  confined  to  the  .simple  inflammatory  affection.  It 
appears  as  an  acute  2i\\^  a  chronic  affection. 

HORSE.       ACUTE    BRONCHITIS. 

This  is  more  frequent  in  the  horse  than  in  other  animals,  and 
178 


Bronchitis. 


179 


especiall}^  so  in  young  animals  when  newly  stabled  or  put  in 
training. 

Ca2cses.  These  are  the  same  as  thos2of  catarrh  and  sore  throat. 
It  is  but  the  continuation  of  the  same  mucous  membrane  which 
is  affected  in  all  alike,  and  the  same  atmospheric  changes,  hot 
stables,  noxious  inhalations  and  exposures  to  cold  and  wet  will  in- 
duce this  disease  rather  than  the  others  when  the  bronchial  mucous 
membrane  is  more  predisposed.  Bronchitis  often  supervenes 
upon  sore  throat,  by  the  extension  of  the  inflammation  down- 
ward into  the  chest.  Chilling  of  the  surface  by  exposure  to  cold, 
drenching  rains,  is  a  frequent  cause,  by  reason  of  the  intimate 
.sympathy  existing  between  the  skin  and  the  mucous  membrane. 
For  the  same  reason  certain  conditions  of  the  skin  will  predispose, 
thus  a  long,  thick  coat  which  keeps  the  animal  constantly 
drenched  with  sweat  and  the  skin  relaxed  and  sensitive.  Will- 
iams draws  attention  to  the  frequency  and  severity  of  bronchitis 
in  both  horses  and  cattle  conveyed  by  sea  during  .stormy  weather, 
and  especially  when  the  hatches  had  to  be  fastened  down.  Such 
an  experience  combines  in  one  the  evils  of  an  overheated  stall,  a 
sudden  transition  often  to  extreme  cold,  a  lowering  of  the  vitality 
of  the  whole  system  by  the  circulation  of  non-aerated  blood,  a 
systemic  poisoning  by  the  retention  of  the  waste  organic  pro- 
ducts that  would  otherwise  have  been  eliminated,  and  the  special 
weakening  of  the  lung  tissue  by  congestion  of  the  whole  pulmonic 
circulation. 

But  the  development  of  bronchitis  and  broncho-pneumonia  is 
the  least  fatal  result.  The  statistics  of  our  European  cattle  traf- 
fic are  rich  in  the  examples  of  absolute  .suffocation  of  cargoes  in 
transit  to  Europe.  The  following  from  Report  of  U.  S.  Treasury 
Cattle  Commission  is  illustrative  : 

' '  Dr.  Thayer  reports  the  case  of  a  steamer  from  Boston  to  Liv- 
erpool, with  400  cattle  on  board,  which  encountered  a  storm  and 
came  through  it  with  only  one  animal  surviving.  Mr.  Toffey,  of 
Jersey  City,  lost  30  head  out  of  a  cargo  of  300  by  suffocation  in 
1880.  This  happened,  he  informs  us,  on  a  calm  sea  on  a  south- 
ern route  with  a  temperature  about  90°  F. ,  and  the  wind  astern 
and  light  so  as  just  to  keep  pace  with  the  ship.  The  air  on  board 
the  ship  became  perfectly  stagnant,  and  there  was  no  means  of  es- 
tablishing an  artificial  current.     A  still  more  disastrous  experience 


i8o  Veterinary  Medicine. 

.befell  the  steamer  Thanemore,  Captain  Sibthorp,  of  the  William 
Johnson  &  Co.  line.  This  vessel  left  Baltimore  with  565  cattle 
on  board,  of  which  228  perished  by  suffocation  before  she  reached 
Cape  Henry.  " 

Among  animals  that  survive  such  treatment  the  susceptibility 
to  lung  disease  including  even  the  contagious  forms  like  tubercu- 
losis is  enormously  enhanced. 

EFFECTS   OF   MODERATELY   VITIATED   AIR. 

"When  air  only  moderately  vitiated  is  breathed  continuously 
for  a  greater  length  of  time  the  results  are  still  very  injurious, 
and  in  the  front  rank  of  diseases  so  caused  stand  pulmonary  con- 
sumption, and  other  destructive  affections  of  the  lungs.  Perhaps 
no  better  example  of  this  can  be  given  than  that  of  the  monkey 
houses  of  the  Zoological  Gardens  of  London  and  Paris.  While 
these  houses  were  small  and  ill-ventilated  the  monkeys  died  in  large 
numbers  from  pulmonary  consumption,  but  after  they  had  been 
enlarged  and  better  ventilated  the  mortality  from  this  cause  nearly 
ceased.      (Arnott.)  " 

"  Town  dairy  cows  which  are  packed  in  close  ill-ventilated 
buildings  and  never  allowed  to  go  out  are  very  subject  to  consump- 
tion, while  horses  kept  in  no  better  conditions,  but  spending  nearly 
half  their  time  in  the  open  air,  rarely  have  phthisis.  (With  lung 
plague  it  will  be  remembered  that  the  out-door  exercise  and  min- 
gling of  herds  leads  to  an  increase  of  the  mortality.)  Horses 
newly  stabled  suffer  severely  from  diseases  of  the  lungs.  The 
same  holds  true  of  human  beings.  A  long  list  of  careful  observ- 
ers have  noticed  the  essential  connection  of  lack  of  ventilation  and 
pulmonary  consumption.  Baudelacque,  Carmichael,  Arnott,  lyC- 
pelletier,  Allison,  Sir  James  Clark,  Toyubee,  Guy,  Greenhow, 
Sir  Alexander  Armstrong,  Parkes,  and  Aitken  have  especially  in- 
sisted upon  consumption  being  a  sequence  of  lack  of  ventilation. 
Dr.  Cormac  indeed  insists  with  great  force  that  consumption  is 
originated  by  rebreathed  air. 

' '  The  notorious  prevalence  of  consumption  in  sailors  has  been 
directly  traced  to  the  impure  air  in  which  they  sleep,  and  an  ex- 
tensive outbreak  of  lung  disease  (not  tubercular),  leading  to 
destruction  of  lung  tissue,  in  the  English  Mediteranean  squadron 


Bronchitis.  i8i 

in  i860  was  clearly  traced  by  Dr.  Bryson  to  the  contamination  of 
the  air.  In  a  nursery  hospital  at  Dublin  with  entire  neglect  of 
ventilation,  2,944  children  died  in  four  years,  whereas  after  the 
ventilation  had  been  improved  only  279  died  in  the  same  length 
of  time.  " 

"  Parkes  (Practical  Hygiene)  says  : 

' '  '  But  not  only  phthisis  may  be  reasonably  considered  to  have 
one  of  its  modes  of  origin  in  the  breathing  of  an  atmosphere  con- 
taminated by  respiration,  but  other  lung  diseases,  bronchitis  and 
pneumonia,  appear  also  to  be  more  common  in  such  circumstances. 
Both  among  seamen  and  civilians  working  in  confined,  close 
rooms,  who  are  otherwise  so  differently  circumstanced,  we  find  an 
excess  of  the  acute  lung  affections.  ' 

In  this  connection,  the  statement  of  the  air  breathed  by  an  ox 
per  hour  and  that  supplied  him  on  board  a  ship  with  insufficient 
ventilation  or  none  may  be  instructive.  The  ox  takes  in  with 
each  breath  about  5  liters  of  air.  This  is  at  the  rate  of  50  liters 
per  minute,  or  3,000  per  hour  =  105.9  cubic  feet.  This  amount 
of  air  is  therefore  rendered  all  but  irrespirable  by  each  animal  in 
the  course  of  an  hour.  And  this,  be  it  noted,  is  by  breathing 
alone,  and  makes  no  account  of  the  contamination  by  perspira- 
tion in  the  overheated  hold,  and  by  the  emanations  from  the  ac- 
cumulating excrement.  " 

' '  On  board  the  steamers  we  have  found  the  space  alloted  to  each 
bullock  to  vary  from  150  to  240  cubic  feet.  On  the  steamship 
"Holland,"  loaded  at  New  York,  August  21,  iSSr,  we  found  the 
stalls  amidships  allowed  the  full  space  of  240  cubic  feet  per  head. 
In  the  bow  where  there  was  less  height  between  the  decks  the 
space  was  considerably  less.  On  the  lower  deck,  where  129  cat- 
tle were  accommodated,  the  space  allowed  each  was  217.4  cubic 
feet.  The  portholes  in  the  upper  deck  were  nine  inches  in  diam- 
eter and  there  was  one  for  each  pair  of  stalls — central  and  lateral 
— or  for  eight  oxen.  These  being  well  above  the  water  line  would 
be  available  for  ventilation  in  ordinary  weather.  The  port-holes 
in  the  lower  deek,  similarly  arranged,  were  about  two  feet  above 
the  water  line,  and  consequently  not  available  for  ventilation,  save 
in  exceptionally  calm  weather.  The  temperature  on  the  main 
deck  of  this  ship  (between  the  outer  and  main  deck),  when  only 
half  the  cattle  had  been  loaded,  was  in  the  neighborhood  of  90° 


1 82  Veterinary  Medicine. 

although  she  was  lying  in  the  center  of  the  North  River  with  port 
holes  and  hatches  open,  and  a  fresh  breeze  blowing  from  the 
north.  " 

' '  On  the  '  Assyriaan  Monarch  '  the  space  per  head  was  only 
192  cubic  feet,  but  this  ship  was  supplied  with  a  ventilating  fan 
or  blower  capable  of  delivering  over  50,000  cubic  feet  of  fresh  air 
per  hour,  so  that  her  ventilation  was  abundantly  provided  for. 
In  some  smaller  ships  we  found  the  space  per  head  to  exceed 
little,  if  at  all,  150  cubic  feet.  In  these,  accordingly,  a  single 
hour  without  any  change  of  air  would  threaten  the  life  of  every 
animal  on  board,  and  two  hours  would  endanger  those  for  which 
even  the  larger  space  is  provided.  It  is  true  that  such  absolute 
seclusion  is  rai'ely  required,  and  that  a  certain  amount  of  aerial 
diffusion  is  always  going  on  through  imperfectly  cloLsed  hatches, 
companion  ways,  and  ventilators,  yet  that  these  are  often  insuffi- 
cient has  been  amply  shown  by  such  losses  as  are  reported  above, 
as  well  as  by  the  bronchitis  and  tuberculosis  which  Drs.  Whitney, 
Lyman,  and  Williams  have  found  in  the  lungs  of  American  ani- 
mals arriving  in  England." 

"  ORGANIC  MATTER  IN  EXPIRED  AIR." 

' '  The  decomposing  organic  matter  given  off  by  the  lungs  and 
skin  is  probably  the  most  injurious  of  the  animal  excreta,  when 
allowed  to  act  on  the  system  for  a  length  of  time.  This  exhaled 
organic  matter  is  easily  recognized  in  the  air  by  chemical  tests,  or 
by  the  putrid  odor  evolved  when  cotton  wool,  that  has  been 
breathed  through,  is  left  to  soak  in  otherwise  pure  water  at  a 
temperature  of  70°  to  80°  Fahrenheit.  The  experiments  of 
Gavarret  and  Hammond,  in  which  expired  air  had  its  carbonic 
acid  and  water  vapor  removed,  leaving  only  the  organic  matter, 
showed  that  the  latter  was  highly  deleterious.  Hammond  found 
that  a  mouse  died  in  forty-five  minutes  in  such  an  atmosphere. 
It  has  also  been  again  and  again  demonstrated  that  air  containing 
a  given  amount  of  carbonic  acid  as  the  result  of  respiration  is  far 
more  poisonous  than  air  which  contains  the  same  amount  of  car- 
bonic acid  as  a  product  of  combustion." 

"  WATER  VAPOR  IN  EXPIRED  AIR." 

"  The  amount  of  water  vapor  given  off   by  the  lungs  varies 


Bronchitis.  183 

greatly  according  as  the  air  is  already  more  or  less  saturated  with 
water.  As  the  air  in  the  stalls  between  decks  is  always  saturated 
with  water  vapor,  we  may  take  the  very  lowest  estimate  for  each 
animal,  namely,  60  ounces  in  24  hours,  which  for  a  cargo  of  200 
head  would  amount  to  over  93  gallons.  And  this  is  in  addition 
to  the  exhalations  from  the  skin  and  the  bowel  and  kidney  excre- 
tions. The  air  between  decks  is  therefore  constantly  saturated 
with  moisture  which  condenses  and  runs  down  in  streams  on 
every  solid  object.  Among  the  ill  effects  of  this  saturation  may 
be  noted  :  ' ' 

' '  First.  The  saturation  of  the  air  with  water  vapor  increases 
the  exhalation  of  carbon  dioxide  from  the  lungs.  This  effect  on 
the  excretion  of  carbonic  acid  is  usually  so  great  as  to  counter- 
balance the  tendency  of  warm  air  to  reduce  the  production  of  this 
acid.  This  saturation,  therefore,  with  water  increases  the  danger 
of  suffocation  by  the  accumulation  of  the  irrespirable  carbon  di- 
oxide in  the  ship,  unless  the  air  is  being  constantly  removed.  " 

"Second.  The  excess  of  moisture  in  the  warm  atmosphere 
hastens  the  decomposition  of  the  organic  matter  derived  from  the 
lungs,  skin,  and  manure.  Sir  Alexander  Armstrong,  head  of  the 
medical  department  of  the  British  Navy,  says  :  "  There  can  be  no 
more  fertile  source  of  disease  among  seamen,  or,  indeed,  other 
persons,  than  the  constant  inhalation  of  a  moist  atmosphere, 
whether  sleeping  or  waking  ;  but  particularly  is  this  influence  in- 
jurious wlien  the  moisture  exists  between  a  ship's  decks,  where  it 
may  be  at  the  same  time  more  or  less  impure,  and  hot  or  cold, 
according  to  circumstances."  It  has  become  an  aphorism  with 
sanitarians  that  "  a  damp  ship  is  an  unhealthy  ship,"  and  many 
instances  are  adduced  in  which  a  sufficient  renewal  of  the  air  be- 
tween decks,  with  or  without  stoves  to  dry  it,  has  transformed  a 
naval  pest-house  into  a  salubrious  vessel." 

"  All  such  considerations  must  emphasize  the  demand  for  such 
a  constant  renewal  of  air  between  decks  on  steamers  carrying 
cattle  as  shall  serve  to  obviate  all  those  conditions  of  ill-health, 
with  congestion  and  inflammation  of  the  lungs,  as  have  proved  in 
the  past  a  serious  drawback  to  our  foreign  cattle-trade.  To  ac- 
complish this  and  at  once  remove  from  between  decks  the  excess 
of  carbon  dioxide,  of  decomposing  organic  matter,  and  of  humidity, 
and  to  furnish  air  approaching  in  purity  and  dryness  that  of  the 


184  Veterinary  Medichic. 

atmosphere  outside,  we  can  conceive  of  nothing  more  simple  and 
effective  than  thorough  ventilation  by  fan  or  heat  extraction,  as 
referred  to  below. "  Report  of  the  U.  S.  Treasury  Cattle  Com- 
mission, 1882. 

The  above  quotations  were  written  with  special  reference  to 
cattle  but  the  author  reproduces  them  here  as  in  principle  applic- 
able to  horses  as  well. 

In  both  horses  and  cattle  treated  as  above  it  is  common  to  find 
ingesta  in  the  bronchia  drawn  in  during  the  violent  paroxy.sms  of 
coughing.  Here  we  have  a  direct  mechanical  irritant  and  a 
means  of  septic  infection,  highly  calculated  to  induce  unhealthy 
broncho-pneumonia.  Williams  quotes  the  case  of  a  horse  in 
which  vomition  was  caused  by  an  over  dose  of  aconite,  and  a  por- 
tion of  the  food  entered  the  bronchi.  , 

In  this  connection  must  be  named  the  introduction  into  the 
bronchia  of  liquids  forcibly  administered  to  horses  and  cattle.  In 
the  horse  the  length  of  the  soft  palate  enables  him  to  hold  liquids 
in  the  mouth  during  his  pleasure,  and  among  the  expedients 
adopted  to  coerce  him  are  the  very  dangerous  ones  of  holding  the 
nostrils  and  of  pouring  the  liquid  through  the  nose.  When  the 
nostrils  are  held  the  urgent  demand  for  air  leads  to  attempts  to 
breathe  through  ihe  mouth,  and,  whether  he  succeeds  in  this  or 
not,  the  usual  result  is  the  drawing  of  a  portion  of  the  liquid  into 
the  lungs.  When  it  is  poured  through  the  nose  the  animal  cannot 
protect  himself  except  by  rapid  gulping,  and  as  he  must  breathe,  a 
portion  of  the  liquid  is  usually  drawn  into  the  lungs.  Any  irritant 
taken  in  this  way  will  develop  bronchitis,  and  some  bland  agents 
like  melted  lard  are  almost  equally  injurious.  Cattle  having  a  short 
palate  can  scarcely  resist  swallowing  liquids  that  are  poured  into 
the  mouth,  but  a  cough  with  the  succeeding  quick  inspiration  will 
almost  certainly  draw  a  portion  into  the  bronchia.  To  return  to 
the  influence  of  cold,  exposed  situations  which  receive  the  full 
force  of  cold  winds,  those  from  the  north  and  west  on  the  Atlantic 
slope  are  specially  conducive  to  bronchitis.  Exposure  of  newly 
clipped  animals  to  stand  without  protection  in  winter  or  early 
spring,  has  the  same  tendency.  Finally  the  inhalation  of  smoke 
or  of  heated  and  irritant  gases  and  vapors,  as  in  a  burning  build- 
ing, is  an  effective  factor. 

Symptoms.     In  its  mildest  form  bronchitis  is  a  transient  illness 


Bronchitis.  185 

with  some  dullness,  impaired  appetite,  hot,  dry  mouth,  redness 
of  the  visible  mucous  membranes,  a  moderately  strong,  resonant 
cough,  attended  with  slight  pain,  slight  rise  of  temperature, 
accelerated  breathing  and  pulse,  and  mucous  discharge  from  the 
nose.  Such  an  attack  passes  over  in  a  few  days  and  without  any 
medicinal  treatment  if  ordinary  precautions  are  taken  to  avoid  a 
repetition  of  its  causes. 

In  severe  cases  the  symptoms  are  more  intense  from  the  first. 
Besides  the  dullness  and  inappetence,  hot,  dry  mouth,  generally 
increased  temperature  of  the  body  (102°  to  104°  F. ),  accelerated 
and  labored  breathing,  and  other  manifestations  of  fever,  there 
are  more  specific  symptoms.  The  cough  is  dry,  hard,  pain- 
ful, often  paroxysmal,  and  appears  as  if  it  came  from  the  very 
depth  of  the  chest.  A  strong,  harsh,  bronchial  sound  is  heard 
over  the  lower  end  of  the  trachea  and  the  upper  border  of  the 
middle  third  of  the  chest  just  behind  the  shoulder.  Percussion 
detects  no  change  from  the  natural  resonance  of  the  chest,  nor 
auscultation  any  crepitating  sound.  Pressure  in  the  intercostal 
spaces  causes  no  suffering.  The  expired  air  feels  hot.  The 
pulse  though  accelerated  is  moderately  soft  and  sometimes  even 
weak,  a  condition  which  marks  inflammations  of  mucous  mem- 
branes as  contrasted  with  those  of  the  serous.  The  mucous 
membrane  of  the  nose  has  a  dark  red  hue,  especially  when  the 
inflammation  extends  to  the  smaller  ramifications  of  the  bronchial 
tubes  so  as  to  impair  the  aeration  of  the  blood.  In  the  same  state 
there  is  excessive  dullness  and  prostration  because  of  the  supply 
of  partially  venous  blood  to  the  brain.  The  head  is  held  low, 
the  nose  often  supported  upon  the  manger,  and  the  eyelids  are 
semi-closed  and  injected. 

From  the  second  to  the  fourth  day  a  free  exudation  takes  place 
from  the  surface  of  the  mucous  membrane,  and  the  symptoms  are 
materially  changed.  The  cough  becomes  more  frequent  but 
softer,  looser,  and  attended  with  a  rattle  from  the  air  passing 
through  the  abundant  mucous  secretion.  The  cooing  or  tubal 
sound  heard  at  the  lower  end  of  the  windpipe  and  behind  the 
shoulder  has  now  given  place  to  a  miicoiis  rale.  A  nasal  dis- 
charge appears  at  first  watery,  thin,  of  a  whitish,  glairy  froth, 
but  .soon  becoming  more  opaque,  white,  milky  and  flocculent  and 
having  little  tendency  to  stick  to  the  nostrils.     This  is  often  ex- 


1 86  Veterijtary  Mediciyie. 

pslled  with  sneezing  and  accompanied  by  movement  of  the  jaws. 
With  the  access  of  free  secretion  there  is  a  great  mitigation  of  the 
fever  and  the  other  distressing  symptoms,  and,  if  no  relapse  nor 
compHcation  supervenes,  recovery  may  be  complete  in  a  fortnight 
or  three  weeks  from  the  onset. 

From  this  time  all  the  febrile  symptoms  decline  and  disappear, 
appetite  and  liveliness  return,  the  discharge  rapidly  diminishes 
and  finally  disappears,  when  the  patient  may  be  said  to  have  com- 
pletely recovered. 

Capillary  and  pseudo-membranous  bronchitis  are  described 
by  Reynal  as  occurring  in  young  horses  recently  brought  into  the 
army  and  subjected  to  the  hot  and  close  stables  in  some  of  the 
French  barracks.  It  began  as  ordinary  bronchitis,  which  in  place 
of  tending  to  recovery,  propagated  itself  to  the  most  minute 
bronchial  ramifications,  and  was  frequently  complicated  by  the 
formation  of  false  membranes.  The  signs  of  its  accession  are  an 
extreme  intensity  of  the  general  symptoms,  the  rapid,  labored, 
difficult  breathing,  accompanied  by  convulsive  action  of  the 
pectoral  and  abdominal  muscles  ;  the  frequent,  painful,  suffocating 
and  abortive  cough,  which  violently  shakes  the  whole  body  ;  the 
extended  head,  open  mouth,  distorted  nostrils,  reddish  brown 
protruding  eyes  ;  the  pinched,  haggard  features,  and  the  frothy 
mucous,  nasal  discharge  striated  with  blood,  and  later  interspersed 
with  shreds  of  false  membrane  similar  to  those  existing  in  croup. 
In  connection  with  these  are  the  symptoms  of  extreme  oppression , 
partial  sweats,  tumultuous  action  of  the  heart  and  small,  weak, 
rapid  pulse.  Death  resulted  from  suffocation  during  a  paroxysm 
of  coughing. 

Course.  Duration.  Termination.  Bronchitis  is  not  usually 
fatal,  except  in  very  young  or  old  or  worn  out  animals,  or  unless 
it  assumes  the  capillary  form  or  is  complicated  by  pneumonia, 
pulmonary  abscess  or  by  metastasis  to  the  bowels  or  feet.  In  the 
mildest  cases  health  is  re-established  in  three  or  four  days,  and  in 
the  severe,  about  the  twelfth,  fifteenth  or  twentieth  da3^  In  old 
and  debilitated  animals  in  which  pure  bronchitis  proves  fatal,  the 
abundant  effusion  into  the  bronchial  tubes,  the  influence  of  gravi- 
tation retaining  this  in  the  smaller  tubes,  the  palsy  of  the 
cilia  which  normally  carry  it  outward,  and  the  want  of  power  to 
expectorate  by  coughing,   usually  bring  about  suffocation.     This 


Bronchitis.  187 

is  favored  by  the  nonserated  state  of  the  blood,  which  rapidly 
prostrates  the  already  weakened  nervous  centres.  The  superven- 
tion of  pneumonia  will  be  marked  by  a  new  class  of  symptoms, 
especiall}'  labored  breathing,  dullness  on  percussion  and  crepita- 
tion on  auscultation.  The  susceptibility  of  the  bowels  is  so  great 
in  some  cases  of  bronchitis,  particularly  in  those  associated  with 
a  low  fever,  that  superpurgation,  enteritis  and  death  may  result 
from  the  smallest  dose  of  laxative  medicine, — the  author  has  seen 
a  fatal  result  from  the  administration  of  two  drachms  of  aloes  in 
a  case  of  this  kind.  In  such  circumstances  the  skin  usually  par- 
ticipates in  an  equal  degree,  and  though  the  superpurgation  be 
checked  an  extension  of  the  disease  to  the  feet  may  still  prove 
fatal  or  induce  such  changes  of  structure  as  to  leave  the  animal 
practically  worthless.  In  old  animals  or  after  repeated  severe 
attacks  of  bronchitis  it  may  merge  into  the  chronic  form.  Thick 
wind  is  a  frequent  sequel  of  severe  cases  from  thickening  or  dila- 
tation of  the  bronchial  tubes,  from  collapse  of  the  lung  or  from 
emphysema. 

Post-mortem  appearances.  In  the  bodies  of  animals  that  have 
died  of  bronchitis  the  air-passages  within  the  lungs  are  filled 
with  a  white  or  greenish  yellow  mucus.  If  this  is  washed  from 
the  tubes  by  a  stream  of  water,  the  mucous  membrane  is  often 
found  to  be  injected,  studded  more  or  less  profusely  with  red 
points  or  with  branching  red  lines,  and  with  petechia,  and  the 
mucous  membrane  is  softened,  sometimes  thickened  and  friable. 
When,  however,  the  bronchitis  has  been  attended  by  a  free  puru- 
lent expectoration  the  mucous  membrane  may,  when  washed, 
show  no  perceptible  alteration  from  the  healthy  standard  as  ex- 
amined by  the  naked  eye. 

In  the  capillary  form  the  blocking  up  of  the  smaller  tubes  by  a 
tenacious  frothy  mucus,  and  by  the  false  membranes  which  form 
complete  casts  of  many  of  the  tubes  and  the  partial  consolidation 
(collapse)  of  circumscribed  pyriform  masses  of  lung  tissue  with 
which  such  tubes  communicate  form  the  chief  features  on  exami- 
tion  after  death. 

This  state  of  consolidation  or  collapse  of  lung  is  frequently  seen 
in  simple  bronchitis  as  well.  It  is  then  due  to  the  blocking  up  of 
one  or  more  bronchia  by  plugs  of  tenacious  mucus  which  act  as 
valves,  preventing  the  entrance  of  air,  though  it  may  permit  of 


1 88  Veterinary  Mediciiie. 

its  eas)'  passage  outward.  This  state  of  lung  differs  materially 
from  the  consolidation  due  to  inflamed  lung  tissue  (hepatisation). 
When  cut  it  does  not  present  the  granular  appearance  of  the  lat- 
ter, caused  by  the  exudation  into  the  minute  air  cells,  but  the  cut 
surface  has  an  uniform  homogeneous  aspect  aptly  likened  by 
Lsennec  to  vnisciUar  fiesh  (splenisation;.  Mendelson,  Traube 
and  Gairdner  have  induced  artificial  collapse  of  the  lung  by  in- 
troducing foreign  bodies  into  the  bronchia  of  animals. 

Emphysema  of  the  margins  of  the  lung  is  a  frequent  concomi- 
tant of  collapse.  The  cause  is  plain.  The  portion  of  lung,  the 
subject  of  collapse,  emptied  of  its  air,  does  not  occupy  a  tithe  of 
the  space  it  would  normally  fill.  The  rest  of  the  lung  tissue  ex- 
pands unduly  to  fill  out  the  vacated  portion  of  chest  and  the  cells 
become  over-distended  and  ruptured.  The  emphysematous  lung 
is  known  by  its  lighter  color,  by  its  irregular  bulging  surface,  by 
the  subsidence  of  these  elevations  when  pricked  with  a  needle, 
and  by  a  more  marked  crepitation  when  pressed.  When  the  cells 
have  burst  and  the  air  escaped  into  the  areolar  tissue  between  the 
lobes,  it  appears  as  dark  lines  circumscribing  small  portions  of 
pulmonary  tissue  and  collapsing  when  pricked. 

Treatment.  The  mildest  cases  will  recover  of  themselves, 
especially  if  care  is  taken  to  protect  the  patients  against  cold,  wet, 
draughts  of  cold  air,  over-exertion,  and  other  injurious  causes, 
and  to  give  a  part  of  the  food  warm  and  sloppy.  In  severe  cases 
treatment  must  be  more  active,  but  it  will  be  borne  in  mind  that 
severe  depletive  measures  are  badly  endured.  Bleeding  danger- 
ously increases  the  already  existing  weakness  and  prostration 
without  affording  any  corresponding  advantage. '  It  is  only  ad- 
missible when  from  the  severity  of  the  symptoms  in  the  early 
stages  suffocation  is  threatened  or  when  the  brain  becomes  in- 
volved in  disease. 

Causing  the  patient  to  inhale  water  vapor  from  scalded  bran  or 
hay  is  to  be  assiduously  carried  on  for  half  an  hour  to  an  hour 
twice  or  thrice  daily  until  expectoration  has  been  freely  e.stabli.shed 
and  the  cough  and  fever  alike  moderated.  The  density  of  the 
vapor  must  of  course  be  apportioned  to  the  particular  case  so  as 
to  avoid  any  approach  to  suffocation.  The  addition  of  the  fumes 
of  burning  sulphur  will  often  by  their  astringent  and  antiphlogistic 
action  on  the  mucous  membrane,  rander  the  vaporous  application 


Bronchitis.  189 

more  effective.  A  pinch  put  into  a  small  piece  of  paper  twisted 
at  one  end  to  prevent  burning  of  the  fingers  may  be  set  fire  to 
and  the  fumes  allowed  to  pervade  the  appartment  so  that  they  can 
be  breathed  freely  without  inducing  cough.  A  mustard  poultice 
to  the  neck  and  sides  of  the  chest  should  also  be  applied  and  kept 
on  an  hour  or  until  effusion  into  the  skin  is  well  marked  \iy  thick- 
ening of  its  substance.  Injections  of  warm  water  should  be  given 
alike  to  check  or  obviate  shivering  and  to  equalize  the  general 
temperature  and  to  solicit  the  action  of  the  bowels.  In  sporadic 
casss  with  active  fever  and  full  strong  pulse  a  laxative  dose  of 
aloes  (3  to  4  drachms)  may  be  given,  but  if  with  a  low  fever  and 
during  the  prevalence  of  influenza  not  more  than  half  the  dose 
should  be  given  or  enemata  alone  ma\'  be  relied  upon.  As  soon 
as  the  medicine  has  .set  or  at  once  if  it  is  withheld,  neutral  salts 
may  be  given  (Liquor  Ammonise  Acetatis  2  oz.  or  Sweet  Spirits 
of  Nitre  i  oz.  or  nitrate  of  potass  ^  oz.  combined  with  10  drops 
tincture  of  aconite  repeated  twice  or  thrice  daily).  If  the  cough 
is  troublesome  and  secretion  long  in  being  established,  expector- 
ants ma}'  bs  used  (oxymel  of  squill  3  oz.,  powdered  squill  J,^  oz. 
or  liquorice  i  drachm)  with  half  the  doses  of  the  neutral  salts. 

In  the  early  stages  to  hasten  expectoration  such  preparations  as 
the  following  may  be  given  : 

Recipe:  Potas.  Bicarb.  2  ounces;  Ammon.  Carb.  2  ounces; 
Digitalis  Pulv.  2  drams.  Mix.  Divide  into  eight  powders  :  give 
one  every  four  hours. 

Recipe  :  Ammon.  Murias.  2  ounces ;  Choral.  Hydrat.  i  ounce  ; 
Tinct.  Hyoscam.  2  fluid  ounces;  Aqua  8  fluid  ounces.  Mix. 
Give  two  tablespoonfuls  ever}-  four  hours. 

Apomorphia,  tartar  emetic,  turpentine  or  benzoin  may  be  em- 
ployed or  even  pilocarpin,  care  being  taken  not  to  increase  pros- 
tration unduly.  Compre.ssed  air,  oxygen  and  peroxide  of 
hydrogen  will  sometimes  relieve. 

With  the  advent  of  expectoration,  or  earlier,  iodide  of  potassium 
in  one  drachm  dose,  thrice  a  daj-  will  do  much  to  obviate  gland- 
ular and  other  enlargement  which  would  tend  to  develop  7-oaring. 

The  diet  should  be  laxative,  non-stimulating  and  somewhat 
spare.  Mashes  of  wheat  bran,  boiled  linseed  or  boiled  barley  ; 
roots  such  as  turnips,  carrots,  beets  ;  in  summer  a  limited  supply 
of  fresh  grass,  with  little  hay  at  any  time  and  that  scalded,  may 


I  go  Veterinary  Medicine. 

indicate  the  nature  of  the  ahments  to  be  used.     As  a  beverage 
chilled  fresh  water  or  linseed  tea  may  be  supplied  ad  libitum. 

Should  the  nasal  discharge  manifest  no  disposition  to  cease  at 
the  end  of  15  or  20  days,  as  will  sometimes  happen  in  young 
horses,  stimulants  and  tonics  must  be  employed.  Gentian  (4 
drachms).  Sulphate  of  iron  (2  drachms),  Arsenious  acid  (5  to  10 
grains  J  or  nux  vomica  (i  scruple)  may  be  given  daily  as  ball, 
electuary  or  powder.  A  full  and  nutritive  diet  should  at  the  same 
time  be  allowed,  and  open  air  exercise  enjoined. 


CHRONIC  BRONCHITIS  IN  THE  HORvSE. 
BRONCHIAL  CATAARH. 

As  Sequel  of  Acute  :  as  result  of  unhygienic  environment,  diet  and  usage. 
Symptoms,  breathing  accelerated,  double  expiratory  act,  short  breath,  cough 
husky,  or  paroxysmal,  excited  b}'  cold  air,  water,  discharge  white  floccu- 
lent.  Percussion,  drumlike  patches  ;  Auscultation  mucous  and  sibilant  rales. 
Lesions,  thick  mucus,  pale  membranes,  bronchiectasis,  emphysema,  ulcera- 
tion. Thick  wind.  Treatment,  stimulating,  tonic,  derivative,  medicated 
vapors,  careful  diet.     Tar  water. 

This  may  be  a  sequel  of  the  acute  form,  or  it  may  appear  at 
once  as  a  catarrhal  discharge  from  the  bronchial  tubes  and  with- 
out any  very  marked  febrile  affection,  in  animals  debilitated  by 
damp  stables,  overwork  and  a  faulty  regimen  and  diet. 

Symptoms.  Respiration  accelerated,  and  expiration  effected 
with  a  double  lifting  of  the  flank  ;  the  lior.se  is  easily  blown  when 
moderately  exercised  ;  the  cough  is  frequent,  soft  or  rattling  and 
paroxysmal — sometimes  hard  and  deep  -  is  excited  when  brought 
from  the  warm  stable  into  the  cold  air,  and  is  followed  by  a 
whiti.sli,  flocculent,  purulent  discharge  from  the  nostrils,  con- 
sistent but  not  sticky  (like  buttermilk).  The  pulse  is  rapid  and 
small  in  volume. 

Percussion  manifests  a  healthy  resonance  over  the  greater  part 
or  all  of  the  chest,  a  drumlike  sound  over  given  areas,  and  auscul- 
tation over  its  median  part  detects  a  bronchial  rattle  and  in  most 
cases  a  dry  sibilant  rale. 

After  death  the  bronchial  tubes  are  found  to  contain  an  abund- 
ance of  thick  mucus,  though  abnormal  redness  of  the  mucous 
membrane  is  by  no  means  a  necessary  condition.  There  is  always 
more  or  less  dilatation  of  the  bronchial  tubes  especially  at  their 
points  of  s-ubdi vision  where  they  are  often  twice  their  healthy 
calibre,  and  an  emphysematous  state  of  the  lungs  is  equally  con- 
stant. Delafond  and  Rodet  have  noted  minute  ulcers  on  the 
bronchial  mucous  membrane  and  Reynal  miliary  abscesses  and 
grayish  and  white  indurations  of  the  lung  tissue  and  bronchial 
glands  which  may  have  been  glanderous. 

It  will  be  observed  that  the  symptoms  and  lesions  closely  re- 
semble those  of  broken  wind  (heaves),  and  unless  early  and  suc- 

191 


192  Veterinary  Medicine. 

cessfuUy  treated,  into  this  it  gradually  merges.  The  chief  dis- 
tinguishing symptoms  are  the  abundance  and  nature  of  the  dis- 
charge, the  fetor  of  the  breath,  and  the  presence  of  the  mucous 
rale  in  the  chest.  It  is  one  of  the  conditions  known  by  the  horse- 
man's expression  "  thick  tvind.''' 

Treatment.  Like  its  type  (dilatation  of  the  bronchia,  bron- 
chiectasis) in  man  this  disease  obstinately  resists  treatment.  In 
our  efforts  to  cure  it  the  same  general  principles  must  be  followed 
as  in  acute  bronchitis,  with  this  grand  qualification  that  the  gen- 
eral aim  must  be  to  stimulate  and  support.  Stimulating  liniments 
may  be  repeatedly  applied  along  the  course  of  the  trachea  and  on 
the  sides  of  the  chest.  An  equable  temperature  is  desirable  and 
a  dry  building.  Water  vapor  medicated  with  various  astringents 
and  antiseptics  (creosote,  carbolic  acid,  turpentine,  tar,  or  tar 
vapor)  is  to  be  commended.  A  course  of  tonic  and  expectorant 
medicine  is  desirable  and  a  highly  nutritious  and  laxative  diet  is 
imperatively  demanded. 

As  tonics  Gentian  may  be  given  daily  in  4  drachm  doses  com- 
bined with  quaiacum  in  do.ses  of  2  scruples.  In  mcst  ca.ses  it  will 
be  advisable  to  add  to  the  above  or  employ  separately  arsenious 
acid  in  doses  of  5  to  10  grains  combined  with  three  times  the 
amount  of  bicarbonate  of  soda,  and  given  daily  for  a  month  or 
longer. 

The  diet  should  be  as  for  broken  wind,  nutritious,  in  small 
bulk,  of  a  laxative  nature  and  given  at  least  an  hour  before  work. 
A  moderate  supply  of  grass,  roots,  bran,  oats  or  barley  may  be 
given,  but  hay  must  be  sparingly  supplied  and,  if  exclusively 
clover  hay,  dry  and  dusty,  is  better  withheld.  In  the  north  of 
France  horses  with  chronic  bronchitis  are  maintained  in  a  service- 
able condition  by  a  diet  of  cut  straw  and  cut  hay,  well  sifted  to 
remove  all  dust  mixed  with  oats  and  molasses  and  set  aside  in  a 
large  cask  to  ferment  before  being  given  to  the  animals.  Tar 
water  may  be  the  exclusive  drink. 

A  pint  of  linseed,  well  boiled,  and  given  daily  for  a  length  of 
time  in  succession  is  often  of  great  value. 


BRONCHITIS  IN  THE  OX. 

Working  oxen  most  susceptible.  Causes,  damp  buildings,  wet,  cold,  ex- 
posed localities.  Debility,  overwork,  poor  feeding,  close,  foul  stables,  sud- 
den changes  of  temperature.  Previous  attacks.  Symptoms,  mild  form, 
and  severe,  fever,  sneezing,  cough,  dry,  later  soft,  prostration,  retraction  of 
nostrils,  labored  breathing,  hot  breath,  discharge,  watery,  milky,  purulent. 
Duration,  Complications  and  sequelae.  Chronic  form.  Respiratory  dis- 
turbance, paroxysmal  cough,  purulent  discharge,  mucous  and  sibilant  rales, 
emaciation.  Lesions.  Treatment,  laxative  safer,  expectorant,  derivative 
stimulant,  etc.,  as  in  horse.     Bronchitis  in  pigs  and  sheep. 

This  is  less  common  than  the  same  disease  in  the  horse,  though 
in  working  oxen,  in  which  many  of  the  same  causes  operate,  it  is 
frequentl}'  seen.  It  is  not  infrequent  in  other  cattle  in  damp 
buildings  or  in  wet  cold  exposed  situations.  Debility  from  over- 
work and  poor  feeding,  often  brings  on  the  chronic  form  of  this 
disease.  Living  out  in  damp  nights  after  a  hard  day's  work  is 
another  frequent  cau.se.  The  enervating  influence  of  the  hot  foul 
air  of  many  cow  houses  conduces  to  it  and  is  specially  injurious 
if  alternated  with  a  chilling  atmosphere  out  of  doors.  Previous 
attacks  strongly  predispose  to  future  ones. 

Symptoms.  Some  cases  are  so  slight  as  to  escape  a  cursory  ob- 
servation and  subsiding  in  a  few  days  leave  the  animal  perfectly 
well.     Others  are  severe  and  may  prove  dangerous. 

The  earlier  symptoms  are  dullness,  staring  coat  or  shivering, 
and  sneezing,  followed  by  reaction  with  hot  clammy  mouth,  gen- 
eral increase  of  temperature,  rapid  pulse,  reddened  nose  and  eyes, 
and  suspended  rumination.  The  more  characteristic  symptoms 
are  a  hard,  dry,  hacking  cough,  not  so  resonant  as  in  the  horse, 
and  soon  a  mucous  discharge  from  the  nose  usually  cleared  away 
by  the  tongue  almost  as  rapidly  as  formed. 

If  the  case  increases  in  severity,  and  in  many  cases  almost  from 
the  first  there  is  great  depression,  hanging  head,  semi-closed  wa- 
tery eyes,  extreme  movement  of  the  nostrils,  hot  expired  air, 
labored  action  of  the  flank,  complete  loss  of  appetite,  constipa- 
tion, faeces  covered  by  mucus,  cough  very  hard,  painful,  oc- 
curring in  paroxysms  and  easily  excited  by  touching  the  larynx 
or  trachea.     This  is  followed  by  a  loose  cough,  a  free  discharge 

13  193 


194  Veterinary  Mcdichie. 

from  the  nose  and  a  mucous  rale  on  auscultation.  Percussion 
gives  healthy  resonance.  The  disease  reaches  its  height  on  the 
fifth  day  and  recovery  may  be  almost  perfect  on  the  eighth.  Its 
chief  danger  is  from  a  complication  with  pneumonia  or  pleurisy, 
or  from  its  merging  into  the  chronic  form. 

Chronic  bronchitis  in  the  ox  is  characterized  by  a  persistent 
disturbance  of  the  respiration,  paroxysms  of  coughing,  a  white 
flocculent  discharge  from  the  nose,  increasing  emaciation,  palor  of 
the  mucous  membranes,  a  mucous  rale  over  the  windpipe  and 
median  part  of  the  chest  and  a  cooing  sound  over  other  points. 
If  left  to  itself  emaciation  becomes  extreme,  the  skin  is  harsh, 
inelastic,  attached  to  the  ribs  and  covered  by  vermin,  and  death 
usually  ensues  from  diarrhoea  or  consumption. 

After  death  the  lesions  are  like  those  seen  in  the  horse,  unless 
there  is  the  complication  of  tuberculous  or  other  disease  of  the 
substance  of  the  lungs. 

Treatment.  Neither  the  general  care  nor  the  remedial  treat- 
ment differs  materially  from  that  for  the  horse.  The  principle 
difference  is  in  the  lesser  liability  to  superpurgation  and  in  the 
preference  to  be  given  to  Epsom  or  glauber  salts  over  aloes  as  a 
laxative.  Either  saline  may  be  given  in  dose  of  one  pound  com- 
bined with  an  ounce  of  ginger  or  other  stimulants,  and  followed 
up  by  similar  diuretics,  expectorants  and  tonics,  as  in  the  horse. 
The  chrojiic  form  is  to  be  treated  as  in  the  horse. 

Pigs  and  sheep  affected  with  bronchitis  must  be  treated  on 
the  same  general  principles  as  the  ox,  only  giving  one-fifth  the 
amount  of  the  different  medicaments,  and  in  the  case  of  the  pig 
oleaginous  purgatives  and  emetics  as  advised  for  the  dog. 


BRONCHITIS  IN  THE  DOG. 

Causes,  damp  kennels,  cold  and  damp  aflei  hunting,  pampering  and  ex- 
posure, distemper.  Symptoms,  fever,  cough  hard,  later  soft,  discharge  wa- 
tery, glairy,  purulent.  In  capillary  bronchitis  cough  more  paroxysmal, 
painful  and  attended  with  vomiting.  Disturbance  of  breathing,  pulse,  tem- 
perature. Fatality  in  different  breeds.  Treatment,  laxative,  expectorants, 
diuretics,  heart  tonic,  calmative,  water  vapor,  chest  jacket,  stimulant  ex- 
pectorants, stimulants,  tonics.     Diet. 

This  is  conitnon  and  severe.  Hotinds  kept  in  damp  kennels, 
much  exposed  to  cold  and  damp  after  being  heated  in  hunt- 
ing, or  subjected  to  freqtient  and  sudden  alternations  of  tem- 
perature are  specially  liable.  Pampered  pets  kept  in  warm 
rooms,  overfed  and  having  little  open  air  exercise,  are  equally- 
subject  to  its  attacks.  It  is  an  usual  form  in  which  distemper  is 
manifested. 

Symptoms.  There  is  roughness  of  the  coat  or  shivering  and  a 
small,  hard  cough  often  repeated.  If  confined  to  the  bronchi  the 
cough  soon  becomes  loose,  a  free  discharge  sets  in,  and  with  care 
recovery  may  be  secured  in  five  or  six  days. 

If  the  smaller  bronchial  tubes  are  involved  the  symptoms  are 
more  intense  and  persistent.  The  temperature  may  reach  104° 
or  105°.  To  the  same  early  symptoms  succeed,  a  painful  cough 
occurring  in  paroxysms  and  sometimes  followed  by  vomiting  of  a 
glairy  mucus.  There  is  running  from  the  eyes  and  nose,  and 
reddening  of  thin  membranes.  The  creature  .stands  with  his 
elbows  turned  out,  his  flanks  heaving  and  his  heart  beating  rap- 
idly and  tumultuously.  In  the  worst  cases  when  the  inflamma- 
tion has  been  propagated  to  the  smallest  bronchial  tubes  consti- 
tuting capillary  bronchitis,  these  symptoms  are  seen  in  their  most 
aggravated  type  and  the  subject  often  dies  of  suffocation,  or  by 
implication  of  the  lung  tissue.  Percussion  and  auscultation  are 
even  more  applicable  than  in  the  larger  animals,  showing  the 
clear  resonance,  of  the  lung  tissue,  the  tubal  murmur  in  the  early 
stages  and  the  mucous  rattle  in  the  later  ones.  In  the  capillary 
form  a  distinct  crepitation  is  heard  like  that  of  pneumonia. 
Bronchitis  proves  most  fatal  to  the  higher  bred  dogs,  such  as  King 
Charles  spaniels,   Italian  greyhounds,  and   English  terriers,  and 

195 


196  Veterinary  Medicine. 

according  to  St.  Cyr  small  dogs  suffer  more  severely  than  large 
ones. 

Treatment.  If  the  bowels  are  costive  a  tablespoonful  of  castor 
oil  should  be  given,  followed  up  by  nauseating  expectorants  and 
diuretics  (tartar  emetic  two  grains,  nitrate  of  potass  one  drachm, 
and  sugar  one  drachm,  mix  thoroughly,  divide  into  twelve  pow- 
ders and  shake  one  on  the  tongue  thrice  daily).  If  the  cough  is 
very  troublesome  two  grains  of  powdered  digitalis  may  be  added 
to  each  dose,  or  after  the  nasal  discharge  has  been  freely  estab- 
lished two  to  four  grains  of  opium  among  the  tartar.  The 
opiates  are  of  great  value  in  controlling  the  paroxysms  of  cough- 
ing and  the  propagation  of  the  disease  to  the  smallest  ramifica- 
tions of  the  air  passages,  but  as  they  check  secretion  they  must 
be  used  with  caution  until  a  free  discharge  has  been  established. 
In  the  early  stages  bromides,  hyoscyannes  or  digitalis  may  be 
preferred.  Muriate  or  carbonate  of  ammonia,  syrup  of  Tolu, 
senega,  or  gnaiac  may  follow. 

Inhalations  of  water  vapor,  the  maintenance  of  an  equable 
temperature,  and  the  moist  chest  jacket,  followed  by  mustard 
poultices  to  the  throat  and  chest  are  not  to  be  neglected.  The 
diet  should  be  simple,  oatmeal  or  Indian  corn  pudding  with  milk, 
soups  and  the  like  may  be  allowed,  but  as  a  rule  butcher  meat  is 
to  be  withheld.  If  the  patient  has  previously  fed  entirely  on  the 
latter  it  should  now  be  given  in  very  limited  amount  only,  and 
qualified  by  an  admixture  of  farinaceous  diet. 

In  some  cases  the  prostration  becomes  so  great  that  the  patient 
must  be  supported  by  tonics  and  stimulants  (a  teaspoonful  each 
of  sweet  spirits  of  nitre  and  tincture  of  gentian,  or  a  teaspoonful 
of  port  wine  repeated  twice  daily). 

In  case  of  persistent  discharge,  iron,  liquor  arsenicalis,  the 
same  strength  as  Fowler's  solution,  or  cod-liver  oil  may  be  used. 


CROUPOUS  BRONCHITIS  IN  CATTI.E  AND  SHEEP. 

Causes,  smoke,  hot  air  or  gas,  irritant  inhalations,  concomitant  of  in- 
fectious diseases.  Lesions,  intense  congestion  covered  by  fibrinous  exu- 
dates. Symptoms,  slowly  or  suddenly  developed,  fever,  loud,  wheezing, 
stertorous,  panting  breathing,  dyspncea,  dry  rales  and  blowing.  Course- 
Treatment,  moist  jacket,  soothing,  expectorant,  stimulant  inhalations,  ex- 
pectorants, derivatives. 

This  affection  has  been  found  in  cattle  and  sheep  from  exposure 
to  smoke,  hot  air  or  gas,  and  other  irritants,  and  even  from  ex- 
posure to  cold,  and  without  any  suspicion  of  a  contagious  ele- 
ment. Again  it  has  been  seen  as  a  complication  in  Rinderpest, 
lung  plague  and  malignant  catarrh.  The  lesions  are  those  of 
tumefaction  and  extreme  arborescent  redness  of  the  mucosa,  and 
the  formation  of  patches  of  a  dense  fibrinous  exudate  of  a  yel- 
lowish color,  in  .some  cases  completely  obstructing  some  of  the 
smaller  tubes. 

Symptoms.  The  attack  may  come  on  slowly  as  in  ordinary 
bronchitis,  while  in  other  cases  it  is  sudden.  The  respiration  be- 
ing loud,  wheezing,  stertorous  and  panting  and  general  dyspoena 
supervening.  Auscultation  furnishes  loud,  blowing  sounds,  dry 
rales  and  rouchi,  while  percussion  may  show  no  abnormal  change. 
A  .strong  tremor  is  felt  by  the  hand  on  the  trachea,  and  after  a 
paroxysm  of  coughing  false  membranes  may  be  expelled.  If 
there  is  no  improvement  by  the  .second  or  third  day  death  is  liable 
to  supervene  by  asphyxia. 

Treatment  is  usually  unsatisfactory.  The  hot,  moist  jacket, 
inhalations  of  vapors  of  warm  water,  of  carbonate  of  ammonia, 
and  of  ether  may  be  tried,  counter-irritants  to  the  chest,  and  in- 
ternally liquor  ammonia  acetatis  and  iodide  of  .sodium  would  be 
indicated.  When  the  membranes  are  somewhat  loo.sened  pilo- 
carpin,  or  in  weaker  subjects  apomorphine  may  a.ssist  their  ex- 
pulsion. 


197- 


ACUTE  CONGESTION  OF  THE  EUNGS.      PUEMONARY 
HYPEREMIA. 

Active  and  passive  congestions.  Congestion  of  incipient  pneumonia. 
Congestion  of  over-exertion.  Causes,  lack  of  condition,  fat,  plethora, 
gorged  stomach,  hot  weather,  cold  rains,  cold  baths,  infectious  diseases. 
Symptoms,  dilated  nostrils,  labored  breathing,  deep  lifting  of  flanks,  pant- 
ing, pendent  head,  staring,  fixed,  bloodshot  eyes,  pale — later  dark  red  nasal 
mucosa,  rapid  julse,  palpitating  heart,  fine  crepitation,  cold  limbs,  tremors, 
perspiration,  obstinate  standing,  till  unable,  blood  from  nose.  Fulminant 
cases.  Exposure  cases.  Course.  Termination.  Resolution.  Lesions, 
lungs  black,  gorged,  do  not  crepitate  nor  collapse,  lessened  buoyancy,  cut 
surface,  compressed  bronchioles  and  alveoli,  right  heart  and  veins  gorged, 
blood  black,  semi-liquid,  petechise.  Nature.  Not  yet  inflammatory,  blocd 
engorgement,  no  cell  proliferation,  migration,  non-exudation,  pulmonary 
vaso-motor  paresis,  effect  of  blood  pressure,  of  peptones,  etc,  of  exhaus- 
tion. Treatment,  relieve  respiratory  muscles,  derivation  to  surface,  stimu- 
lants, hot  pediluvia  and  packs,  relief  of  vascular  sj-stem,  bleeding,  heart 
stimulants,  digitalis. 

Congestion  of  the  kings  occurs  in  all  animals  as  the  percursor 
of  inflammation,  but  as  death  may  occur  without  the  superven- 
tion of  actual  inflammation  a  special  notice  appears  to  be  de- 
manded. The  hypersemia  of  the  lungs  may  be  seen  in  two  forms, 
active  and  passive,  the  latter  form  being  secondary  to  other 
diseases,  such  as  valvular  diseases  of  the  left  heart,  by  reason  of 
which  the  blood  is  forced  back  on  the  lungs  and  creates  mechani- 
cal congestion.  The  active  form  is  a  pathological  process  devel- 
oped in  the  lung  itself,  and  which  often  proves  fatal  through 
arrest  of  the  circulation  through  this  organ. 

Causes.  The  pulmonary  congestions  preceding  pneumonia  are 
due  to  the  .same  causes  with  that  disease.  The  most  typical, 
acute  and  deadly  form  of  pulmonary  congestion  is  usually  due  to 
over-exertion  in  an  animal  that  is  fat  and  out  of  condition.  The 
English  hunting  field  presents  the  most  typical  specimens.  A 
horse  that  has  just  left  the  dealer's  hands,  or  that  is  plethoric, 
fat,  soft  and  flabby,  is  ridden  over  a  heavy  country,  and  though 
he  may  perform  well  for  a  few  miles,  he  soon  hangs  heavily  on 
the  bit,  slackens  his  pace,  and  if  not  pulled  up,  staggers  and  falls 
"all  of  a  heap."  A  farm  horse,  taken  from  grass  or  other,  soft 
198 


Acute  Congestion  of  the  Lnngs.   Pubnonary  Hyperccmia.     199 

feeding,  and  entirely  out  of  condition  often  suffers  in  the  same 
way,  in  going  perhaps  for  the  veterinarian  in  case  of  urgent 
colic  in  one  of  its  fellows.  Cruzel  draws  attention  to  similar  con- 
gestions from  over-exertion  in  fat  cattle,  and  Trasbot  in  wild 
stags  and  hogs  when  beechnuts  and  acorns  were  abundant,  in 
pampered  family  horses  and  in  plethoric  farm  animals  generally. 
Excessive  heat  (heat  apoplexy)  is  invoked  as  a  cause,  and  the 
arrest  of  hgematosis  and  consequent  stagnation  in  the  pulmonary 
capillaries  are  undoubtedly  accessory  causes,  yet  the  majority  of 
cases,  and  the  most  typical  and  fatal,  occur  in  the  winter  season 
(the  hunting  season).  On  the  other  hand,  chills  from  rains  or 
cold  draughts,  especially  when  heated  and  exhausted,  are  com- 
mon causes,  and  the  disease  often  comes  on  more  gradually, 
attaining  its  acme  after  five  or  six  hours.  A  horse  perspiring 
after  a  hard  drive  and  left  to  face  a  cold  blast  unblanketed,  or  one 
plunged  by  accident  into  ice  cold  water  for  ten  minutes  (Trasbot) 
are  examples  of  this  kind.  These  cases  are  ushered  in  by  violent 
rigors,  whereas  in  those  due  to  over-exertion  this  is  much  less 
marked  and  is  usually  only  suggested  by  the  coldness  of  surface 
and  extremities.  Another  condition  which  contributes  to  pul- 
monary congestion  is  a  full  stomach.  The  plentitude  of  the  ab- 
dominal organs  leads  to  compression  of  the  lungs  and  hampered 
circulation,  and  when  to  this  is  added  over-exertion  and  exhaus- 
tion acute  congestion  is  speedily  induced. 

Acute  congestions  are  noticed  as  an  accompaniment  of  other 
diseases,  but  these  are  mostly  either  the  localization  in  the  lung 
of  a  specific  morbid  process  (anthrax,  influenza,  distemper, 
strangles),  or  it  is  due  to  auto-poisoning,  as  when  the  cutaneous 
transpiration  is  suppressed  by  a  coating  of  glue,  or  to  embolism. 

Symptoms.  In  the  horse  which  fails  under  severe  exertion 
there  are  the  dilated  nostrils,  the  labored  breathing,  the  deep, 
almost  convulsive  action  of  the  flanks,  the  hanging  on  the  reins, 
the  slacking  of  the  pace,  the  unsteadiness  of  gait,  and  lastly  the 
fall.  There  may  now  be  noticed  the  protruded  bloodshot  e3^es, 
the  agonized  expression  of  countenance,  the  extended  head,  the 
pallor,  and  later  the  blueness  of  the  nasal  mucous  membrane,  the 
short,  panting  breathing,  accompanied  by  a  roaring  noise  alike  in 
inspiration  and  expiration,  and  the  small,  weak,  rapid  pulse 
often  imperceptible  at  the  jaw.     If  the  animal  has  been  stopped 


200  Veterinary  Medicine. 

short  of  having  fallen,  or  if  he  is  able  to  get  upon  his  feet,  he 
stands  with  his  limbs  apart  to  secure  his  stabilit3^  and  with 
the  elbows  turned  out  to  facilitate  the  expansion  of  the  chest. 
As  the  breathing  becomes  panting  the  respirations  are  less  deep, 
the  ribs  are  maintained  permanently  drawn  outward,  and  the 
flanks  rise  and  fall  to  a  limited  extent  only  but  with  great  rapidity 
(eighty  to  one  hundred  per  minute).  Auscultation  may  detect 
at  first  an  increase  in  the  pitch  of  the  respiratory  murmur,  and 
the  presence  of  the  finest  possible  crepitation  soicnd.  Soon  the 
murmur  decreases  uniformly.  The  extremities  are  cold,  and  in 
this  coldness  the  general  surface  to  some  extent  participates  even 
though  it  may  be  covered  by  perspiration.  Tremors  or  rigors 
are  present.  The  heart  is  felt  behind  the  left  elbow  to  beat 
tumultuously.  If  blood  is  drawn  it  flows  in  a  thin,  black,  tary 
stream. 

In  some  cases  blood  more  or  less  frothy  is  discharged  from  the 
nostrils  as  the  result  of  rupture  of  pulmonary  vessels. 

In  the  fulminant  cases  in  cattle  respiration  is  rapid,  even  pant- 
ing, wheezing,  the  expiration  attended  by  a  hoarse  grunt,  some- 
times nasal  hemorrhage,  great  prostration,  profuse  perspiration,  a 
.stupor  sets  in  and  the  animal  falls  and  dies,  with  more  or  less 
struggling. 

In  the  cases  which  develop  more  slowly,  and  as  the  result  of 
cold  and  chill  whether  in  horses  or  cattle,  there  is  dullness,  anor- 
exia, prostration,  increasing  rapidity  and  oppre.s.sion  of  the  breath- 
ing, a  small,  frequent,  hoarse  cough,  and  at  first  distinct  pallor  of 
the  conjunctiva  and  pituitary  mucosa,  with  more  or  less  trembling. 
The  head  is  extended  on  the  neck,  toward  an  open  door  or  win- 
dow, if  available,  until  prostration  and  .stupor  forbid.  The  pulse 
is  small,  thready,  often  almost  imperceptible  and  much  accelerated, 
while  the  heart  beats  are  .strong,  violent,  tumultuous.  For  a  time 
the  respiration  may  be  not  more  than  double  the  normal  rythm, 
but  it  tends  to  more  or  less  rapid  increase  with  wheezing  or  ster- 
torous sounds  and  shaken  by  trembling  of  the  respiratory  muscles. 
The  nasal  discharge  is  slight  and  grayish  often  with  streaks  of 
blood.  If  it  increases  the  cough  becomes  looser  and  .softer. 
Quite  early  the  respiratory  murmur  decreases  over  the  whole  lung 
and  a  blowing  sound  from  the  bronchia  or  larnyx  is  heard  on 
the  upper  middle  third  of  the  chest.     This  may  be  complicated  by 


Acute  Congestion  of  the  Lungs.   PulmoJiary  Hypercemia.     201 

a  mucous  rale,  or  when  ligemorrhage  has  supervened  by  a  loud 
rattling.  Percussion  shows  a  lack  of  resonance  over  the  whole 
lung,  not  so  flat  and  definitely  circumscribed  as  in  pneumonia  but 
a  partial  flatness  of  sound  over  the  v^'hole  chest.  In  pneumonia  a 
limited  area  of  lung  is  absolutely  solidified  (hepatized)  while  the 
remaining  lung  is  practically  normal,  whereas  in  acute  congestion 
often  the  whole  lung  is  gorged  with  blood  but  for  some  time  no 
part  of  it  is  entirely  divested  of  air. 

Another  marked  feature  is  the  maintenance  at  first  of  the  nor- 
mal temperature  with  only  a  slight  rise  of  about  1°.  This  serves 
to  distinguish  congestion  of  the  lungs  from  sunstroke  (heat  anhge- 
matosis)  in  which  the  temperature  usually  rises  to  108°  or  110°  F. 
or  higher.  The  temperature  rises  however  as  the  disease  advances 
and  merges  into  pneumonia.  Another  distinguishing  feature 
from  sunstroke  is  the  early  pallor  of  the  mucous  membranes  which 
in  heat  apoplexy  are  strongly  congested.  In  congestion  they  be- 
come dark  red  only  with  the  advance  of  the  disease  and  the  ad- 
vent of  asphyxia.  These  features  serve  also  to  distinguish  acute 
pulmonary  congestion  from  contagious  fevers,  pneumonia  and 
other  inflammations  of  internal  organs. 

Course.  Termination.  The  more  acute  (fulminant)  forms  are 
promptly  fatal.  In  the  exhausted  system  the  lungs  have  become 
uniformly  gorged  with  blood,  which  can  no  longer  be  forced 
through  the  capillaries  by  the  right  heart,  the  heart  in  turn  is 
overdistended  with  blood  and  ceases  to  beat  and  death  ensues  in  a 
few  minutes. 

In  the  less  acute  cases  the  patient  survives  twenty-four  hours 
and  upward,  the  whole  lung  not  being  equally  implicated  but  only 
certain  lobules,  usually  the  lower,  or  the  congestion,  if  uniform  in 
all  the  lung,  being  less  extreme. 

In  favorable  cases  recovery  takes  place  in  one  or  two  days. 
There  is  a  return  of  life  and  appetite,  a  gradual  improvement  in 
pulse  and  breathing,  the  respirations  becoming  deeper  and  longer, 
and  in  a  few  hours  all  the  more  violent  symptoms  may  have  dis- 
appeared. With  a  more  gradual  improvement  recovery  may  still 
be  complete  in  four  or  five  days. 

Lesions.  When  the  subject  has  died  suddenly  the  appearances 
are  essentially  those  of  uniform  engorgement  of  the  pulmonary 
capillaries  with  blood.     The  general  aspect  is  a  dark  red,  varying 


202  Veterinary  Medicine. 

from  reddish  brown  to  black,  the  darkest  shades  corresponding  to 
circumscribed  areas  of  actual  haemorrhage.  •  In  the  worst  cases 
the  whole  mass  may  appear  like  black  currant  jelly.  The  lungs 
do  not  collapse  when  the  chest  is  opened,  they  are  more  or  less 
friable  at  various  points,  and  different  portions  will  sink  or  float 
in  (not  on)  water,  according  as  it  may  be  more  or  less  airless.  A 
dark  liquid  blood  exudes  freely  from  the  torn  or  cut  surface. 
Sections  of  the  lung  tissue  hardened  and  examined  under  the  mi- 
croscope show  the  alveoli  and  bronchioles  devoid  of  exudate,  but 
having  their  cavities  compressed  and  obliterated  by  the  pressure 
of  the  swollen  mucosa,  and  its  investing  blood  clot.  The  heart 
is  overdistended  with  fluid  blood.  In  asphyxiated  cases  the  gen- 
eral venous  system  is  filled  with  black,  liquid  blood,  and  the  se- 
rosse  spotted  with  petechise. 

Nature.  The  nature  of  this  disease  is  variously  luiderstood. 
It  differs  from  inflammation  in  the  absence  of  active  cell  prolifier- 
ation,  and  migrations  of  inflammatory  exudation,  and  of  fever  at 
all  proportionate  to  the  extent  of  the  lesions.  All  these  may  and 
do  supervene  if  the  patient  survives  but  they  are  practically  ab- 
sent for  a  length  of  time  at  the  outset.  Some  attribute  it  to  pare- 
sis of  the  vaso-motor  centres  for  the  lungs,  as  the  result  of  their 
over  .stimulation  and  of  the  retrocession  of  blood  from  the  chilled 
surface  to  the  internal  organs.  But  congestions  caused  by  cut- 
ting the  cervical  branch  of  the  sympathetic  nerve  or  the  sciatic 
plexas  are  not  marked  b}'  a  .similar  blood  extrava.sation  and  de- 
.struction  of  tis.sue.  The  delicate  structure  of  the  lung  tissue  and 
the  comparative  absence  of  mechanical  support  will  account  for 
this  in  part,  the  great  force  of  the  circulation  overloading  the  cap- 
illaries, under  the  impulse  of  the  heart  so  closely  adjacent,  has 
doubtless  a  certain  effect,  and  the  venous  nature  of  the  blood  thus 
forced  into  the  lungs  and  calculated  to  arre.st  all  normal  function 
has  a  potent  influence.  If  we  add  to  this,  for  the  over-exertion 
cases,  the  sudden  advent  into  the  circulatory  stream  of  unchanged 
peptones  and  other  ingredients  of  the  portal  blood  of  highly  fed 
and  plethoric  animals  we  find  a  sufficiently  pathogenic  combina- 
tion. In  all  acute  cases  however  the  adiposity,  poor  condition 
and  susceptibility  to  speedy  exhau.stion  must  be  given  their  full 
share  of  responsibility. 

Treatment.     Girths,  saddles  and  anything  else  that  may  hamper 


Acute  Congestion  of  the  Lungs.   Pulmonary  Hyperccmia.     203 

the  movement  of  the  chest  must  be  at  once  removed  and  the 
horse's  head  turned  to  the  wind,  an  active  stimulant  given  and  the 
legs  well  rubbed  and  loosely  flannel  bandaged.  The  nature  of 
the  stimulant  is  of  less  consequence  than  its  prompt  administra- 
tion. Two  ounces  of  chloroform,  of  sulphuric  ether,  or  of  sweet 
spirits  of  nitre  ;  half  a  pint  of  whisky,  brandy  or  gin  ;  or  a  pint 
of  any  of  the  more  stimulating  wines  may  be  given,  diluted  in 
warm  water  so  as  to  remove  tli2ir  irritating  qualities.  A  drink 
of  warm  gruel  will  often  go  far  to  restore  warmth  to  the  surface 
and  to  unload  the  overtaxed  lungs.  Frequent  large  injections  of 
warm  water  have  a  similar  effect.  Active  hand  rubbing  of  the 
legs  and  the  wrapping  of  them  loossly  in  flannel  bandages  pre- 
viously warmed  at  the  fire  is  equally  valuable.  If  a  roomy,  well 
ventilated,  loose  box  can  be  obtained  the  horse  should  be  led  to 
it  gently  and  a  light  but  warm  rug  placed  upon  the  body.  Valu- 
able derivation  may  be  obtained  from  pediluvia,  the  feet  and  legs 
up  to  the  knees  and  hocks  being  put  in  buckets  of  water  as  hot 
as  the  hands  can  bear,  and  at  the  same  time  actively  rubbed.  If 
this  is  impossible  the  legs  may  be  wrapped  in  bandages  and  wet 
with  hot  water  every  few  minutes.  Or  this  soothing  derivative 
agent  may  be  applied  as  well  to  the  surface  of  the  chest.  A 
blanket  wrung  out  of  hot  (nearly  boiling)  water  until  it  no 
longer  drops  is  wrapped  round  the  body  and  covered  up  with  two 
or  three  dry  rugs.  A  second  smaller  rug  is  wrung  and  placed  on 
the  neck  and  covered  by  a  sufficiency  of  hoods  to  keep  in  the 
heat.  The  legs  are  meanwhile  hand  rubbed  and  bandaged  and 
the  other  measures  above  recommended  carried  out  to  restore  the 
circulation  in  the  surface  and  extremities.  The  time-honored 
practice  of  bleeding  freely  from  the  jugular  vein  is  one  of  the 
most  effective  means  of  relieving  the  over-charged  heart  and 
lungs,  and  should  be  resorted  to  at  the  earliest  possible  moment. 
The  blood  will  at  first  flow  in  a  small,  dark  stream,  but  as  the 
circulation  obtains  relief  the  jet  will  increase  in  volume  and  the 
general  symptoms  will  improve.  From  four  to  six  quarts  may 
be  taken  wdth  advantage  from  an  ordinary  horse.  This  is  not  a 
pneumonia  but  an  overloaded  heart  and  lungs,  threatening  speedy 
death  and  which  the  abstraction  of  blood. promptly  relieves. 

The  longer  the  bleeding  is  delayed  the  less  effective  it  is.     It 
should  not  supersede  the  other  measures  already  recommended. 


204  Veterinary  Medicine. 

There  is  no  real  paradox  in  both  bleeding  and  giving  stimulants 
in  such  a  case,  as  the  essential  condition  is  one  of  weakness,  and 
if  the  abstraction  of  blood  has  been  of  use  in  relieving  the 
clogged  heart  and  lungs,  the  depression  under  which  these  have 
labored  may  be  still  further  overcome  by  agents  calculated  to 
rouse  their  suspended  vitality. 

Trasbot  strongly  recommends  large  doses  of  tartar  emetic  and 
iodide  of  potassium  to  reduce  the  blood  pressue  in  the  lungs,  an 
advice  which  will  be  received  with  hesitation  by  those  who  dread 
the  already  paretic  condition  of  the  heart.  His  combination  of 
iodide  of  potassium  with  digitalis  will  be  more  confidently  re- 
sorted to.  One  drachm  of  the  former  may  be  given  with  a  half 
drachm  of  the  latter  twice  daily. 

With  the  advent  of  marked  fever  and  other  signs  of  pneumo- 
nia, the  treatment  for  that  disease  should  be  resorted  to. 


PUIvMONARY  CEDEMA. 

Causes,  pneumonia,  extra  force  of  right  heart  or  weakness  of  left,  insuffi- 
ciency of  mitral  valves,  deflection  of  blood  by  obstruction  in  one  portion  of 
hing,  pressure  of  tumor  on  pulmonary  veins.  Malignant  oedema.  Malig- 
nant catarrh.  Bright's  disease.  Anaemia.  Parasitism.  Symptoms,  ab- 
normal heart  sound,  or  urinary  secretion.  Parasitism.  Percussion  shows 
flat  sound  auscultation  lowered,  respiratory  murmur,  heightened  blowing. 
No  crepitation.  Expectoration  serous.  Prognosis  grave.  Treatment,  at- 
tacks primary  disease.  Posture.  Elimination.  Dry  capping.  Heart 
tonic. 

A  dropsy  of  the  lung  tissue  may  supervene  in  weak  conditions, 
in  the  course  of  inflammatory  disease  of  the  lungs  ;  it  may  also 
depend  on  an  imperfect  balance  in  the  forces  of  the  right  and  left 
heart  respectively,  which  leads  to  the  habitual  throwing  of  blood 
pres.sure  back  upon  the  lungs.  Still  more  frequently  the  conges- 
tion and  dropsy  depends  on  insufficiency  of  the  mitral  valves  by 
reason  of  which  a  reflux  of  blood  toward  the  lungs  takes  place 
at  each  heart-beat.  The  pressure  of  tumors  on  the  pulmonary 
veins  may  have  a  similar  action.  Obstruction  of  circulation  in 
one  portion  of  lung  may  cause  an  extra  blood  pressure  on  an  ad- 


Piibnonary   QZdevia.  205 

jacent  one,  and  oe:lenia  so  caused  may  be  found  especially  in  cattle 
and  pigs  in  which  the  interlobular  connective  tissue  is  specially 
abundant.  This  may  be  seen  in  miliary  tuberculosis  in  cattle,  and 
it  probably  contributes  to  produce  the  extraordinary  liquid  col- 
lections that  characterize  lung  plague.  In  cattle  also  malignant 
oedema  may  affect  the  lung,  and  an  oedematous  condition  is  some- 
times met  with  in  malignant  catarrh.  Bright's  disease  is  another 
cause,  the  ursemic  dropsy  finding  a  favorite  seat  of  election  in 
the  loose  lung  tissue  unsupported  by  solid  tissues.  The  anaemia 
resulting  from  parasitism  like  distomato.sis  may  similarly  affect 
the  lung. 

The  symptoms  of  pulmonary  oedema  will  usually  be  compli- 
cated by  those  of  the  affection  causing  it.  Thus  modification  of 
the  first  heart  sound  or  of  the  urinary  secretion,  or  the  existence 
of  parasitism,  would  furnish  valuable  indications. 

The  physical  signs  of  lung  disease  vary.  If  pneumonia  is 
present  it  is  betrayed  by  its  characteristic  symptoms.  In  the  ab- 
sence of  inflammation  there  is  dullness  on  percussion  over  the 
affected  area,  and  on  auscultation  an  absence  of  the  respiratory 
murmur,  and  perhaps  abnormal  clearness  of  bronchial,  cardiac 
and  other  sounds  from  deeper  parts.  It  differs  from  pneumonia 
in  the  absence  of  fever  and  of  any  crepitation  surrounding  the 
consolidated  portion.  The  expectoration  is  serous  or  watery, 
rather  than  rusty  or  purulent. 

The  prognosis  is  always  grave  in  proportion  to  the  incurable 
nature  of  the  primary  disease.  Chronic  valvular  or  Bright's 
disease,  miliary  tuberculosis  or  malignant  tumors  would  render 
the  case  hopeless,  while  in  acute  pneumonia,  or  nephritis  or  para- 
sitism there  may  be  some  hope.  The  treatment  will  largely  con- 
sist in  the  therapeutics  of  the  primary  disease,  yet  we  may  also 
seek  to  relieve  the  dangerous  symptoms  of  oedema.  The  fre- 
quent change  of  position  may  serve  to  limit  hypostatic  accumula- 
tion. Diuretics  or  purgatives  in  strong  patients  will  favor  ab- 
sorption. Pilocarpin  more  than  any  other  agent  secures  tem- 
porary absorption  but  cannot  be  continued  owing  to  its  depressing 
effects.  Digitalis  is  often  valuable  in  improving  the  heart's 
action,  and  acting  freely  on  the  kidneys.  Dry  capping  on  the 
chest  acts  as  a  derivative. 


ATELKCTASIS.  COLLAPSE  OF  LUNG. 

Atelectasis  iu  bronchitis,  congenital,  etc.  Airless  condition  in  the  ab- 
sence of  exudation.  Causes,  congenital  persistence  in  butcher  animals. 
Blocking  of  air  tubes  by  exudate — ball  valve.  Desquamation  of  ciliated 
epithelium.  Compression  by  hydrothorax,  pneumothorax,  and  false  mem- 
brane. Symptoms.  Percussion  flatness,  juvenile  respiration  elsewhere, 
blowing  sounds  loud.  Drum  like  sounds  on  emphysema  and  pneumothorax. 
Cyanosis.  Lesions,  depressed,  flesh-like,  non-crepitating  lobules  or  lobu- 
letes,  sink  in  water,  dilatable.  Treatment,  rouse  respiratory  centres,  douches, 
cold  and  warm,  slapping,  electricity,  forced  inspiration,  diet,  massage. 
Treat  attendant  disease. 

This  has  been  already  referred  to  as  a  result  of  bronchitis,  but 
it  deserves  special  mention  as  a  sequel  of  that  affection,  and  in  va- 
rious domestic  animals,  as  an  independent  condition.  The  condi- 
tion is  one  of  consolidation  of  lung  by  the  complete  exclusion  of 
air,  but  without  any  infiltration  of  its  sub.stance  by  inflammatory 
exudate  or  dropsical  effusion.  The  tissue  remains  in  its  normal 
state  apart  from  the  fact  that  its  bronchioles  and  air  sacs  are  undi- 
lated.  The  affected  portion  has  a  solid  dark  fleshy  appearance. 
The  collap.sed  portion  often  represents  one  lobule  or  group  of  lo- 
bules which  communicate  with  a  single  bronchium. 

Causes.  In  some  instances  the  conditions  remain  from  birth, 
the  lobule  never  having  been  called  into  use.  This  is  seen  espec- 
ially in  cattle  and  other  meat  producing  animals,  in  which  active 
breathing  is  .systematically  suppressed  in  the  interests  of  rapid 
growth  and  the  deposition  of  fat.  In  the  improved  breeds  the 
lungs  remain  larger  than  the  exigencies  of  the  life  demand,  and 
large  portions  remain  out  of  use.  In  bronchitis  the  condition  is 
acquired,  and  is  mainly  dependent  on  the  blocking  of  a  bronchial 
tube  with  tenacious  mucus  or  a  dcssicated  mass.  The  pathologi- 
cal lesions  of  bronchitis  favor  this  since  one  of  the  earliest  changes 
in  the  inflamed  mucosa  is  the  desquamation  of  the  columnar 
epithelium.  This  removal  of  much  of  the  cilia  and  the  paralysis 
of  much  of  what  is  left  annihilates  for  a  time  the  normal  method 
of  clearing  away  the  secretion,  and  this  being  now  produced  in 
excess  blocks  the  tubes.  This  secretion  virtually  acts  like  a  ball 
valve  in  favoring  the  exit  of  the  air  during  the  convulsive  expira- 
206 


Atelectasis.      Collapse  of  Liuig.  207 

tion  of  coughing,  and  hindering  its  entrance  during  the  succeed- 
ing inspiration.  The  bronchia  and  bronchioles  decrease  in  size  to 
near  their  termination,  so  that,  as  forced  out  in  coughing,  the  se- 
cretion enters  the  larger  tube  and  allows  the  exit  of  air,  which  as 
drawn  back  in  inspiration  it  enters  the  smaller  tube  and  closes  it 
against  any  possible  serial  entrance.  Mendelssohn  and  Traube 
demonstrated  this  action  by  introducing  a  shot  into  a  dog's  lung, 
and  in  two  days  the  left  lung  was  found  collapsed  and  the  right 
one  the  seat  of  complementary  emphysema.  The  violence  and 
frequency  of  the  cough  therefore  bears  a  ratio  to  the  occurrence 
and  extent  of  atelectasis.  Other  causes  are  the  compression  of 
the  lower  lobes  of  the  lung  by  hydrothorax,  b)^  pneumothorax 
(developed  by  lacerated  lung  or  perforated  chest  wall)  or  by  a 
false  membrane  contracting  in  process  of  organization. 

Symptoms.  As  a  congenital  condition  in  the  improved  meat 
producing  animals  the  condition  is  rarely  recognized  in  life  and 
cannot  be  said  to  be  a  defect.  The  collapsed  lobule  being  farther 
removed  from  the  air  may  be  a  more  favorable  field  for  the  growth 
of  pathogenic  bacteria,  but  on  the  other  hand  these  do  not  so 
readily  penetrate  it  as  if  the  tubes  were  open.  When  the  collapse 
is  more  extensive,  the  contrast  in  the  flatness  on  percussion  and 
indistinctness  of  the  respiratory  murmur  on  the  affected  side,  and 
the  marked  resonance  and  loud  murmur  on  the  other,  may  serve 
to  identify  the  affection.  In  extensive,  traumatic  cases  this  con- 
trast is  much  more  prominently  marked,  as  the  expanded  portions 
have  to  take  on  extra  compensatory  work  and  are  not  infrequently 
rendered  emphysematous.  The  drum-like  .sound  in  percussion  of 
such  parts,  and  in  the  upper  part  of  the  chest  in  pneumothorax 
are  pathognomomic  of  these  conditions.  Again  in  hydrothorax 
the  horizontal  upper  level  of  the  area  of  dulness  betrays  a  liquid 
cause.     Severe  cases  are  marked  by  cyamosis. 

The  lesio7is  seen  in  atelectasis  consist  in  depressed  areas  of  a 
dark  fleshy  color  on  the  surface  of  the  lung,  usually  sharply  lim- 
ited by  the  borders  of  the  lobules,  and  in  strong  contrast  with  the 
bulging,  light  colored  lobules  adjacent,  which  are  often  emphy- 
sematous. The  collapsed  lobule  may  usually  be  dilated  when  air 
is  forced  into  the  bronchium,  but  if  it  has  been  of  some  standing 
this  is  often  difficult  or  impo.ssible.  If  it  has  resulted  from  bron- 
chitis or  compression  of  a  previously  inflated  lung  it  will  often 


2o8  Veterinary  Medicine. 

float  ill  (not  on)  water,  from  a  little  retained  air,  but  in  congen- 
ital atelectasis  it  is  airless  and  sinks  to  the  bottom. 

When  /rm/;;/^'w/ is  demanded  it  will  vary  according  to  the  cause. 
In  congenital  atelectasis  the  respiratory  centres  mu.st  be  roused. 
The  new  born  animal  may  be  sprinkled  alternately  with  ice  cold 
and  hot  water,  or  the  chest  ma}'  be  slapped  with  the  palm  of  the 
hand  or  a  wet  towel.  The  nostrils  must  be  cleared  of  mucus,  and 
the  lungs  inflated  by  blowing  or  bellows,  the  larynx  being  pressed 
back  against  the  gullet  to  prevent  inflation  of  the  stomach.  If 
available  electricity  may  be  applied  to  the  chest  walls.  These 
measures  may  be  repeated  at  intervals  and  the  .systemic  weakness 
overcome  by  nourishing  food,  stimulants  and  friction  of  the  skin. 

In  acquired  atelectasis  we  should  seek  to  correct  the  disease  to 
which  it  owes  its  existence.  In  bronchitis  the  measures  already 
indicated  for  the  liquefaction  and  removal  of  the  expectoration 
will  be  in  order  ;  in  hydrothorax  a  judicious  paracentesis  and  in 
pneumothorax  the  aspiration  of  the  gas,  and  the  closure  of  any 
traumatic  opening  through  which  that  gas  has  gained  access. 


HEMOPTYSIS. 

Causes,  over-exertion  in  plethoric,  glanders,  pulmonary  tubercle, 
petechial  fever,  embolism,  aneurism,  ulcerated  new  formations,  anthrax, 
septicEeinia,  hseniorrhagic  diathesis.  Symptoms.  Inappetence,  cough, 
cold  limbs,  rigor,  hard  pulse,  jugular  pulse,  violent  heart  beats,  unsteady 
gait.  Discharge,  bloody,  crimson,  frothy,  with  cough,  without  acid,  ex- 
cited breathing,  debility.  Indications  from  pre-existing  disease.  Treat- 
ment, quiet,  elevated  head,  cold  irrigation,  ice  bags,  acetate  of  lead,  opium, 
ergot,  matico,  tannin,  iron,  oil  of  turpentine,  laxatives,  cool  stable. 

The  term  hcEmoptysis  (al/jia,  blood,  Trruw,  I  spit,)  is  now  entirely- 
restricted  to  bleeding  from  the  lungs  and  lower  air-passages.  It 
is  a  very  rare  complaint  in  the  lower  animals,  but  is  sometimes 
seen  in  both  horse  and  ox.  In  very  plethoric  subjects  the  over- 
loaded circulatory  organs  give  way  in  the  delicate  membrane, 
lining  the  ultimate  bronchial  tubes  and  the  air  cells.  The  ex- 
citing cause  in  such  cases  is  usually  some  severe  effort  of  draught, 
a  violent  gallop,  or  other  unwonted  exertion.  It  occurs  in  gland- 
ers from  rupture  of  caseated  pulmonary  nodules.  It  does  not 
appear  to  be  so  common  in  phthisis  in  the  lower  animals  as  in 
man,  but  one  case  occurred  under  the  eye  of  the  writer  in  which 
the  bursting  of  a  large  tubercle  in  the  lung  of  a  cow  involved  the 
rupture  of  a  considerable  vessel  with  a  fatal  result.  Pulmonary 
embolism  and  infarction,  petechial  fever,  aneurism,  ulcerated 
neoplasms,  anthrax,  and  septicaemia  are  additional  causes. 
Lastly  haemoptysis  sometimes  takes  place  in  hsemorrhagic  sub- 
jects without  any  appreciable  rupture  of  vessels,  the  blood  sweat- 
ing from  the  surface  of  the  bronchial  mucous  membrane. 

Premonitory  symptoms  are  sometimes  noticed,  such  as  dul- 
ness,  and  lassitude,  loss  of  appetite,  a  frequent  short  cough, 
coldness  of  the  limbs  and  surface,  shivering,  full,  hard  pulse, 
pulsation  in  the  jugulars,  tumultuous  action  of  the  heart,  and  un- 
steadiness of  gait. 

More  commonly  it  comes  on  suddenly  as  the  result  of  severe 
muscular  strain  or  excitement.  The  blood  flows  from  the  nose, 
and  rarely  from  the  mouth  in  solipedes,  but  indiscriminately  from 
both  in  other  animals.  It  is  bright  red,  clear,  frothy,  or  mixed 
with  mucus,  and  variable  in  amount.  It  is  easily  distinguished 
14  209 


2IO  Veterinary  Medicine. 

from  nasal  haemorrhage,  which  is  not  frothy,  and  from  bleeding 
from  the  stomach,  which  is  clotted  and  blackened,  with  an  acid 
odor  from  the  presence  of  the  gastric  juice.  The  cough  of  haem- 
optysis contrasts  with  the  sneezing  of  epistaxis  and  the  retching  of 
haematemsis.  The  rattling  cough  increases  the  discharge,  as  does 
also  a  dependent  position  of  the  head.  Besides  the  cough  there 
is  usually  an  anxious  countenance,  accelerated  breathing  and  con- 
siderable lifting  of  the  flank.  When  the  loss  is  excessive  there 
is  weakness,  giddiness,  rolling  of  the  eyes,  and  pallor  of  the  visi- 
ble mucous  membranes. 

The  previous  ill-health  of  the  patient,  the  presence  of  tubercle 
as  ascertained  by  auscultation  and-  percussion,  and  the  haemor- 
rhagic  constitution  as  shown  by  occurrence  of  bleeding  from 
other  parts  of  the  system  will  lessen  the  chances  of  a  favorable 
termination.  Sometimes,  too,  the  flow  is  so  profuse  that  the 
blood  cannot  be  coughed  up,  and  filling  the  bronchial  tubes  it 
destroys  life  suddenly  by  suffocation. 

Treattnent.  When  brought  on  by  severe  exertion  absolute 
quiescence  will  usually  check  haemoptysis.  Keeping  the  head 
in  an  elevated  position  favors  its  arrest.  The  application  of  cold 
water  to  the  head,  neck  and  thorax,  and  the  giving  of  iced  water, 
strongly  acidulated  by  vinegar  or  one  of  the  mineral  acids  may 
sometimes  be  required.  In  threatening  or  obstinate  cases  one 
drachm  of  acetate  of  lead  may  be  given  thrice  daily  to  check  by 
its  astringent  effect  on  the  vessels,  and  the  addition  of  a  drachm 
of  opium  is  of  great  value  in  suppressing  the  cough.  Ergot, 
tannin,  matico,  and  oil  of  turpentine  have  each  been  employed 
with  advantage,  and  when  costiveness  exists  a  saline  laxative 
(one  pound  sulphate  of  soda)  may  be  usefully  resorted  to.  The 
patient  should  be  kept  in  a  cool,  airy  dwelling,  and  should  rest 
for  fifteen  or  twenty  days  after  an  attack. 


PULMONARY  APOPLEXY.      HEMORRHAGIC  INFARC- 
TION. 

Different  forms.  Embolism  with  infarction.  Embolism  from  arteritis. 
Rupture  of  blood-vessel.     Changes  in  color.     Symptoms.     Repair. 

Hgemorrhage  into  the  lungs  may  be  :  ist.  Petechial  in  infec- 
tious diseases.  2d.  interlobidar  as  from  ruptured  vessels.  3d. 
Infarctio7i  or  apoplexy.  hifarctio7i  results  from  embolism  of  a 
branch  of  the  pulmonary  artery,  which  may  in  its  turn  be  due  to 
clots  formed  in  a  diseased  heart  or  in  the  systemic  veins  and  car- 
ried to  the  lungs  in  the  blood  stream.  It  may  also  result  from 
inflammation  of  the  inner  coat  of  the  pulmonary  artery.  A  vir- 
tual stasis  occurs  beyond  the  embolism,  and  the  blood  filtering  in 
through  the  anastomosing  capillaries  fills  and  blackens  the  affected 
lobule.  With  rupture  of  a  considerable  vessel  the  blood  escapes 
en  masse  and  appears  like  black  currant  jelly.  As  it  ages  it  be- 
comes granular  and  changes  to  a  yellow  color,  or  it  may  form  a 
necrotic  mass  enclosed  in  a  cyst  as  in  lung  plague.  The  symp- 
toms, apart  from  the  absence  of  respiratory  murmur  and  resonance, 
are  not  diagnostic.  It  may  take  months  to  undergo  liquefaction 
and  absorption.  Iodide  of  potassium,  bitters  and  stimulating 
diuretics  may  be  given. 


2IZ 


PNEUMONITIS;  PNEUMONIA;  INFLAMMATION 
OF  THE  LUNGS. 

Definition.  Inflammation  of  the  spongy  tissue  of  the  lungs  un- 
complicated by  that  of  the  bronchia  or  pleura. 

Divisions.  This  affection  has  been  variously  divided  according 
to  seat,  7iat2cre,  and  complications  :  thus  : 

Single  Pneumonia  :  Affecting  one  lung  :  7'ig-lit  or  left. 

Double  Pneumoiiia  :   Affecting  both  lungs. 

Lobar  Pneumonia  :  Affecting  one  lobe  or  by  lobes. 

Lobular  Pneumonia  :  Affecting  by  lobules. 

Acute  Pneumonia  :  Subacute  Pneumonia.      Chronic  Pneumonia. 

Croupous  or  Fibrinous  :  With  fibrinous  exudate. 

Catarrhal :  With  exudate  rich  in  cells  and  granules. 

HcE7norrhagic :  With  extravasation  of  blood. 

Purulent :  Tending  to  pus  :  abscess. 

Necrotic:  Tending  to  gangrene  :  sequestra. 

Desquamative :  With  great  proliferation  of  alveolar  epithelium. 

Literstitial.  Interlobular :  Affecting  mainly  the  interlobular 
connective  tissue. 

Hypostatic :  Dependent  on  gravitation  of  the  blood. 

Metastatic:  Due  to  embolism. 

Parasitic:  Caused  by  parasites.  Due  to  wounds  or  foreign 
bodies. 

Contagious  and  Traumatic  Pjiezimonia. 

Many  of  these  are,  however,  but  localizations  of  the  same  affec- 
tion and  others  are  manifestly  microbian  diseases  which  in  the 
present  .state  of  pathology  it  is  not  always  easy  to  early  distinguish 
.sufficiently 'for  clinical  and  therapeutic  purposes.  For  the  sake  of 
convenience  therefore  pneumonia  will  here  be  treated  of  generally, 
and  under  the  headings  devoted  to  etiology,  pathology,  thera- 
peutics, etc.,  attention  will  be  given  to  distinctions.  Those  pneu- 
monias that  are  but  pulmonary  manifestations  of  other  diseases — 
influenza,  glanders,  tuberculosis,  strangles,  contagious  pneumo- 
enteritis,  lung  plague,  septicgemia,  pyaemia,  swine  plague,  hog 
cholera,  petechial  fever,  actinomycoses,  and  neoplasms  will  be  con- 
sidered under  these  respective  headings. 

212 


ACUTE    CROUPOUS    PNEUMONIA.      PNEUMONITIS    IN 
THE  HORSE. 

Definition.  Differentiation  from  acute  vascular  congestion.  Predisposing 
causes,  age,  sex,  stabling,  training,  diet,  impure  air,  low  health,  previous 
limg  disease,  plethora,  climate,  season,  exciting  causes,  chill,  fatigue,  leuco" 
maines,  sudor,  draughts,  plunging  iu  or  spraying  with  cold  water,  clipping, 
inhalation  of  irritant  smoke,  gas,  dust,  drawing  of  food,  irritating  or  insolu- 
ble drugs  into  the  lungs,  neoplasms,  parasites,  contusions,  fractured  ribs, 
punctures,  contagion,  plurality  of  germs,  bacillus  of  Friedlauder,  micro- 
coccus of  Talaraon  and  Fraukel,  diplococcus  pneumonise  equina  of 
Scbiitz,  diplococcus  pneumoniae  equina  of  Cadeac.  Symptoms,  chill, 
hyperthermia,  dullness  on  percussion  and  crepitation  in  the  lower  part 
of  the  lung,  reaction,  congested  mucosa,  accelerated  labored  breathing, 
excited  circulation,  pulse  oppressed,  cough  deep,  patient  statant,  elbows 
everted,  nose  protruded,  nostrils  dilated,  approaching  door  or  window, 
pinched  countenance,  skin  dry,  harsh,  adherent,  partial  sweats,  loins  iusensi" 
ble,  nasal  discharge  rusty,  dependent  part  of  lung  largely  non-resonant,  with 
peripheral  crepitation.  Blowing  in  abnormal  situation  over  hepatized  lung. 
Decubitus,  its  significance.  Course.  Results.  Favorable  indications  in 
pulse,  breathing,  face,  temperature,  appetite,  decubitus,  clearing  of  lung. 
Unfavorable  indications  in  breathing,  pulse,  fever,  face,  uneasy  movements, 
pawing,  cold  limbs,  prostration,  nervousness,  weakness.  Sabacuto  Pneu- 
monia. Terminations  of  pneumonia,  death,  resolution,  splenization,  abscess, 
gangrene,  red  hepatisation,  gray  hepatisation,  fibrinous  consolidation. 
Lesions.  Congestion,  exudation  and  cell  growth,  hepatization — red  and 
gray,  deliquescence,  abscess.  Blood,  loss  of  red  globules,  increase  of  white, 
excess  of  fibrine,  glandular  swelling,  pleurisy,  degenerations  in  other  organs, 
laminitis,  rheumatism.  Treatment,  adapted  to  strength  of  subject  and  type 
of  disease,  hygienic,  anti-rigor,  antiphlogistic,  expectant,  stimulant,  anti- 
pyretic, febrifuge,  sedative,  moist  compresses,  derivatives,  laxatives.  In 
subacute  form  tonics,  heart  stimulants,  febrifuge.  In  chronic  cases  add  rich 
digestible  diet,  and  easy  open  air  life. 

This  consists  in  inflammation  of  the  spongy  tisstie  of  the  lung 
involving  mainly  and  primarily  the  walls  of  the  alveoli  and  inter- 
lobular connective  tissue  with  their  respective  trophic  centres 
(nuclei).  The  acute  congestion  of  excessive  heart  action  and  de- 
bilitated pulmonary  capillaries  described  above,  is  primarily  a 
disease  of  the  bloodvessels  which  become  over  distended  and  ma}-- 
or  may  not  lead  to  the  inflammatory  processes  in  their  walls  and 
the  tissues  adjacent.     Pneumonia  on  the  other  hand  is  essentially 

213 


214  Vetej'inary  Medicine. 

inflammation  of  these  tissues  and  nuclei,  with  exudatiou  usually 
of  a  fibrinous  material  into  their  substance. 

Predisposing  Causes.  ^.  Age.  A  very  early  age  is  nearly 
exempt,  and  from  6  j^ears  upward  there  are  fewer  cases  relative  to 
the  equine  population,  variations  that  may  be  bstter  accounted  for 
by  stabling,  training  and  acquired  immunity  than  by  the  mere 
fact  of  age.  Of  237  cases,  2  were  3)^  years  ;  32  were  4  years  ; 
19  were  5  years  ;  131  were  6  to  11  years  ;  46  were  over  11  years ; 
and  7  of  uncertain  age  (Trasbot).  2.  Sex.  No  visible  effect. 
3.  Stabling,  training,  change  of  food.  While  the  young  colt 
at  pasture  is  practically  immune,  the  period  of  stabling,  transi- 
tion to  a  dry  and  grain  diet,  and  to  the  nervous  excitement  at- 
tendant on  training  and  unwonted  work  as  shown  in  the  statistics 
of  Percivall  and  Trasbot  determine  an  enormous  increase  of  cases. 
In  a  cavalry  regiment  Percivall  found  that  56.6  per  cent,  of  all 
lung  diseases  occurred  before  the  5th  year,  and  Trasbot  found 
that  at  the  Alfert  Veterinary  College  13.5  per  cent,  of  all  equine 
pneumonias  occurred  in  the  4th  year.  4  Hot  Stables.  Impure 
Air.  These  two  conditions  usually  coexist  and  prove  potent 
causes  especially  in  young  horses  brought  from  the  fields.  We 
cannot,  however,  separate  this  cause  as  usually  observed  from  the 
action  of  pathogenic  germs  which  are  preserved  and  concentrated 
in  such  places.  5.  Poor  Health.  Debilitating  diseases,  insuf- 
ficient and  poor  diet,  overwork,  exposure  to  cold  draughts  or 
darkness  and  any  other  cause  which  lowers  the  vitality  predis- 
poses. 6.  A  Previous  Attack.  This  usually  leaves  some  struc- 
tural or  functional  change  which  renders  the  lung  more  sus- 
ceptible to  a  subsequent  invasion.  Against  this  must  be  placed 
the  immunity  which  follows  the  contagious  forms,  but  as  this  is 
usually  exhausted  in  the  course  of  six  months  it  does  not  invali- 
date the  position  that  the  permanent  impairment  of  pulmonary  in- 
tegrity is  a  predisposing  cause.  7.  Plethora  Tending  as  this 
does  to  congestion  it  must  be  accepted  also  for  the  next  patho- 
logical step — pneumonia.  8.  Climate  and  Season.  This  is 
notoriously  an  important  factor.  At  Paris,  Trasbot  met  with  237 
cases  in  the  nine  months  from  October  to  June  inclusive  and  but 
8  ca.ses  in  the  summer  months — July,  August  and  September.  In 
Great  Britian,  where  the  vicissitudes  are  le.ss  .severe  Percivall  had 
in  the  cavalry  horses  in  the  seven  months  from  October  to  April 


Acute  Croupous  Pneumonia.    Pyieiunonitis  in  ihe  Horse.     215 

inclusive  146  cases  =  20.85  per  month,  and  in  the  5  months  from 
May  to  September  inckisive  62  cases  =  12.4  per  month. 

Exciting  Caicses.  Nearly  all  the  above  causes  when  acting  with 
unusual  force  may  become  direct  factors  in  causation.  The  ef- 
fect of  a  sudden  and  extreme  chill  is  especially  to  be  feared. 
Even  in  cases  that  are  unquestionably  due  to  a  microbe  as  the  es- 
sential cause,  the  nervous  disorder  manifested  in  the  chill,  and  the 
clogging  of  the  pulmonary  circulation  in  connection  with  the  re- 
trocession of  blood  from  the  surface  of  the  body  furnishes  the  op- 
portunity for  the  colonization  of  the  germ.  The  average  horse 
at  pasture  will  stand  with  impunity  cold  storms  of  rain,  snow,  and 
sleet,  and  transitions  from  a  warm  noonday  sun  to  a  cold  night 
wind  and  dew  and  even  frost,  but  under  other  conditions  of  the 
system,  with  the  fatigue  and  fret  and  sudden  changes  of  food  and 
regimen  attendant  on  domestication,  or  with  any  derangement  of 
an  important  bodily  function  the  chill  is  often  the  manifest  occa- 
sion of  disturbance  of  the  balance  of  health,  and  the  supervention 
of  pneumonia.  Fatigue,  a  system  charged  with  leucomanies, 
and  a  free  perspiration,  which  is  suddenly  checked  by  exposure, 
at  rest,  to  a  cold  ram  ,  or  snow,  to  a  draught  between  door 
and  window,  to  immersion  in  the  cold  waters  of  a  river,  or 
to  sponging  with  cold  water  is  quite  liable  to  cause  pneumonia. 
An  unduly  heavy  winter  coat,  an  individual  peculiarity  or  deter- 
mined by  a  cold  environment  in  autumn  often  predisposes  strongl}^ 
to  such  dangerous  chills,  by  the  frequency  and  profuseness  of  the 
perspirations  and  general  relaxation  of  the  system.  Clipping  of 
such  subjects  is  a  true  hygienic  measure  though  it  entails  the 
need  of  extra  care  in  blanketing.  Again  in  the  animal  that  has 
already  suffered  from  disease  of  the  respiratory  organs  these 
chills  are  more  dangerous  factors. 

Direct  irritation  by  inhalation  of  smoke  and  other  products  of 
combustion  ;  or  acrid  or  irritant  gases  or  dust  ;  by  the  drawing  of 
food  by  aspiration  into  the  lungs  (as  in  paralysis  of  the  larnyx  or 
pharnyx,  choking,  apoplexy,  vomiting,  etc.)  ;  b}^  pouring  irri- 
tant or  insoluble  drugs  (oil,  lard)  through  the  nose  ;  by  the  pres- 
sure of  neoplasms  Tactinomycosis,  tubercle,  glanders,  cancer)  ;  or 
by  the  presence  of  parasites  (strongyles,  distomata,  echinococci, 
linquatulas. 

Pncujnonia  from  Contusion  of  the  chest,  fracture  of  a  rib,  or 
puncture  or  laceration  of  the  lung  is  recognized. 


2i6  Veterinary  Medicine. 

Contagion.  The  presence  of  a  contagiiim  in  pneumonia  is  to- 
day well  established.  Clinical  observation  had  indicated  this 
even  before  the  discovery  of  a  specific  germ,  but  recent  bacterio- 
logical investigations  and  the  transmission  of  the  disease  by  inoc- 
ulation of  artificial  cultures  have  definitely  settled  the  question. 
It  does  not  follow  that  all  cases  are  contagious,  nor  equally  so,  but 
the  recognition  of  the  contagious  form  satisfactorily  explains  the 
prevalence  of  the  disease  in  one  stable  while  an  adjoining  one  es- 
capes, and  the  eruption  of  new  cases  in  a  stable  after  an  animal 
affected  with  the  disease  or  convalescent  from  it  has  been  intro- 
duced. It  has  been  objected  that  many  horses  stand  in  the  stable 
with  pneumonia  cases  and  escape,  but  so  is  it  with  glanders,  cow- 
pox,  and  many  other  affections.  It  merely  argues  an  immunity 
in  the  case  of  some,  and  for  the  disease  germ  a  very  limited 
transmissibility  through  the  air.  The  further  objection  that  the 
existence  of  lesions  in  the  lung  before  the  onset  of  fever,  excludes 
this  from  the  list  of  infectious  diseases,  is  untenable  since  many 
undeniably  contagious  diseases,  like  cutaneous  anthrax,  glanders, 
lung  plague,  cowpox,  appear  locall}'  before  any  constitutional  dis- 
turbance occurs,  which  later  as  the  result  of  extensive  local  dis- 
ease and  the  circulation  of  toxins  in  the  blood.  It  places  conta- 
gious pneumonia  however  in  that  long  list  of  infectious  diseases 
which  develop  first  locally  in  the  seat  of  infection  and  later  become 
more  or  less  generalized. 

It  must  be  admitted  however  that  the  germ  of  pneumonia  is 
not  the  same  for  all  cases  of  the  disease  and  for  all  genera  of  ani- 
mals. It  must  also  be  allowed  that  the  same  germ  does  not  al- 
ways maintain  the  same  degree  of  virulence,  and  that  it  may  even 
live  for  a  time  on  the  buccal  mucosa  of  an  animal  belonging  to  a 
susceptible  genus  without  any  morbid  result.  In  short  we  must 
recognize  that  different  germs  of  pneumonia  may  become  tem- 
porarily non-virulent  or  only  slightly  virulent,  and  remain  patho- 
logically quiescent,  as  for  example  during  the  summer  months, 
to  reassert  itself  later  when  the  conditions  become  more  favorable 
to  its  pathogenesis. 

BACTERIOIvOGY. 

a.  Bacillus  of  Frikdla.nder.  This  is  a  short  rod  with 
rounded  ends,  often  merely  oval,  occurring  in  pairs,  or  chains  of 


Acute  Croupous  Pneumonia.    Pneumonitis  in  the  Horse.     217 

four,  and  under  given  circumstances  surrounded  by  a  transparent 
gelatinous  capsule.  It  is  serobic,  noumotile,  does  not  liquefy 
gelatine,  nor  sporulate,  and  in  gelatine  stick  cultures  has  a  nail- 
like growth.  This  was  found  by  Friendlander,  Frobenius, 
Weichselbaum  and  Wolf  in  the  pulmonary  alveoli  in  a  small  pro- 
portion of  cases  of  croupous  pneumonia  in  man.  The  cultures, 
injected  into  the  lungs  of  animals,  killed  one  dog  (out  of  five),  six 
Guinea  pigs  (out  of  eleven),  and  thirty-two  mice  (all  the  in- 
jected). Ivesions  were  intense  congestion  of  the  lungs,  seropuru- 
lent  pleural  effusion,  and  enlarged  spleen,  while  the  bacillus 
swarmed  in  the  blood  and  exudate. 

Micrococcus  Pneumonias  Croupos^.  First  found  by  Stern- 
berg in  his  own  saliva  in  health,  and  by  Pasteur  in  the  saliva  of  a 
rabid  child.  Afterward  found  in  the  great  majority  of  lungs 
affected  with  croupous  pneumonia  in  man,  by  Talamon,  Salvioli, 
Sternberg,  Frankel,  Weichselbaum,  Netter,  Gamalei,  etc.  I^ater 
it  was  found  in  meningitis,  in  ulcerative  endocarditis,  in  ar- 
thritis, in  otitis  media,  and  in  acute  abscess  in  man. 

It  is  a  spherical  or  oval  coccus,  arranged  in  pairs,  in  fours,  or  ex- 
ceptionally in  eights  or  tens.  Lanceolate  forms  are  the  rule  in 
the  blood  of  animals,  and  circular  in  artificial  cultures.  It  stains 
readily  in  aniline  colors  and  by  Gram's  method,  grows  inordinary 
culture  media,  at  37°  C.  in  the  absence  of  free  acid,  and  in 
gelatine  stick  cultures  as  small,  white  colonies  along  the  line  of 
culture,  without  liquefying  the  gelatine.  It  dies  in  ten  minutes 
at  52°  C.  (Sternberg).  Its  virulence  lessens  in  artificial  cul- 
tures, but  is  restored  by  passing  through  the  body  of  a  suscepti- 
ble animal. 

Injection  into  the  lungs  or  trachea  of  rabbits,  mice,  sheep  and, 
less  certainly,  Guinea  pigs,  produced  distinct  fibrinous  pneumonia 
filled  with  the  microbe.  In  dogs,  subcutaneously,  it  caused  ab- 
scess, but  in  the  lungs  an  acute  fibrinous  pneumonia  which  only 
exceptionally  proved  fatal,  recovery  usually  taking  place  in  ten  to 
fifteen  days. 

Klemperer  induced  immunity,  sometimes  lasting  six  months, 
by  intravenous  injection  of  filtered  cultures. 

DiPLOCOCCus  Pneumonia  Equina.  First  found  by  Schiitz  in 
the  lungs  of  pneumonic  horses  in  1887.  It  is  an  oval  coccus  ar- 
ranged usually  in  pairs  or  in   threes  or  fours,  and  surrounded  by 


2i8  Veterinary  Medicine. 

a  transparent  envelope.  It  stains  in  aniline  colors  but  not  by 
Gram's  method.  It  is  aerobic  and  ^rows  in  gelatine  at  ordinary 
temperature  without  liquefying  it,  and  in  stick  cultures  forms  a 
line  of  small,  white,  separate  colonies  which  do  not  coalesce  by 
growth.  Does  not  grow  on  the  surface  of  the  gelatine  around 
the  puncture.  Line  cultures  on  agar  are  in  colonies  like  minute 
transparent  droplets.     In  bouillon  it  develops  long  chains. 

Inoculated  on  the  rabbit,  Guinea  pig  and  mouse,  it  produced 
death  with  pneumonic  affections  (hsemorrhagic  congestion  or  in- 
flammation), but  it  failed  to  take  in  some  of  the  rabbits  and  Guinea 
pigs.  Chickens  and  pigs  proved  immune.  Injected  into  the 
horse's  lung  or  as  .spray  into  the  trachea  it  produced  true  croup- 
ous pneumonia.  Fiedaler  and  others  obtained  similar  results. 
Peter  has  found  the  faeces  of  pneinuonic  horses  virulent,  an  im- 
portant point  in  connection  with  disinfection. 

Schiitz  found  that  20  grammes  of  the  culture,  in  an  equal 
quantity  of  boiled  water,  injected  into  the  horse's  trachea,  pro- 
duced a  rise  of  temperature  by  two  or  three  degrees,  with  rigors, 
cough,  accelerated  pulse,  elevated  temperature,  dyspncEa  and 
prostration,  but  that  this  subsided  in  a  few  hours.  By  repeating 
this  every  thirty-six  hours,  the  fourth  or  fifth  would  fail  to  pro- 
duce a  reaction  and  the  subject  proved  immune. 

Cadeac's  Diplococcus  Pneumonia  Equina.  In  the  lungs 
of  cases  of  contagious  pleuro-pneumonia  of  the  horse  Cadeac  found 
a  round  noncapsulated  coccus  appearing  in  pairs,  or  rarely  in 
chains,  and  staining  by  Gram's  method.  It  grew  slowly  in 
bouillon  and  agar  at  37°  C,  forming  on  the  latter  in  twenty-four 
hours,  a  thick,  whitish,  oily  drop,  which,  as  it  grew  larger,  as- 
sumed a  ."^ilvery  whiteness,  and  dried  in  the  centre.  In  bouillon 
it  precipitated  a  powdery  sediment.  The  reaction  of  the  culture 
medium  was  unchanged.  It  lost  virulence  rapidly  in  artificial 
cultures  or  by  a  heat  of  50°  C. ,  and  it  died  in  ten  minutes  at  a 
temperature  of  60°  C.  Virulence  vfz.9,  long  retained  whtn  dried, 
or  even  in  putrid  material. 

This  proved  infecting  to  the  ass,  rabbit  and  Guinea-pig,  while 
the  cat  and  white  rat  proved  immune.  Intratracheal  injection 
of  the  dog  produced  a  transient  pneumonia.  The  ass  inoculated 
with  the  blood  of  the  infected  rabbit  died  in  three  days,  with  a 
hepartzed  lung,  pleurisy,  and  swarms  of  the  microbes  in  the  lungs, 


Acute  Croupojis  Pncumoyiia.     Pneumonitis  in  the  Horse.   219 

blood  and  internal  organs.  Rabbits  injected  intravenously  had 
enlarged  spleen,  reddish  exudate  in  the  serous  cavities,  urine 
stained  with  haemoglobin,  and  lungs  and  kidneys  congested. 
With  intratracheal  injections  the  lesions  were  exclusively  pul- 
monary. The  pulmonary  lesions  were  less  constant  in  the  Guinea- 
pig.  Weakened  virus  caused  pulmonary  lesions  only  without 
.septicaemia. 

It  has  been  suggested  that  this  coccus  is  at  least  closely  related 
to  that  of  pneumo-enteritis  of  the  horse. 

Sympto7ns.  The  onset  of  pneumonia  is  not  often  seen  by  the 
veterinarian,  who  is  called  in  only  after  the  cough,  loss  of  appe- 
tite, hurried  breathing  and  rigor  has  revealed  illness  to  the  at- 
tendants. Hence  perhaps  chill  and  rise  of  temperature  have  been 
placed  among  the  earliest  symptoms.  The  symptoms  are  more 
violent  in  the  racer,  trotter  and  other  nervous  animals.  Trasbot 
positively  claims,  that  considerable  pulmonary  inflammation  and 
even  exudation  have  taken  place  before  there  is  any  chill  or  rise 
of  temperature.  This  is  especially  the  case  in  the  heavy  lym- 
phatic races  of  draught  horses,  which  often  according  to  this 
author  perform  their  usual  work  for  days  after  inflammatory 
exudation  has  set  in.  A  fair  counterpart  of  this  is  found  in  lung 
plague  of  cattle  and  it  would  indicate  that  both  start  from  a  local 
infection,  which  gradually  extends  until  the  systemic  derang- 
ment  is  induced.  As  usually  seen,  and  especially  when  it  follows 
exposure  to  severe  cold,  a  staring  coat  or  a  shivering  fit  usher 
in  the  disease,  the  degree  of  the  chill  bearing  some  ratio  to  the 
coldness  of  the  air  and  to  the  future  severity  of  the  malady.  This 
may  be  accompanied  by  a  small,  dry  cough,  but  without  any  other 
marked  sign  of  lung  disease.  With  the  access  of  the  hot  stage 
the  characteristic  symptoms  of  lung  disease  are  manifested,  at  first 
resembling  those  of  congested Imigs,  but  less  severe  than  those  given 
under  that  head.  There  is  a  distinct  increase  of  the  body  tem- 
perature ;  the  visible  mucous  membranes  are  suffused  with  a  blush  ; 
the  expired  air  feels  hot  upon  the  hand  ;  the  breathing,  30  to  40 
per  minute,  is  short  and  accompanied  by  much  lifting  of  the 
flanks — {labored^  ;  the  cough  is  deep  as  if  coming  from  the  depth 
of  the  chest,  but  not  so  hard  nor  .so  painful  as  in  bronchitis  ;  the 
legs  are  placed  apart,  the  elbows  turned  out  and  the  head  pro- 
truded to  facilitate  breathing  ;  the  nose  is  turned  to  an  open  door 


220  Vctermajy  Medicine. 

or  window  if  any  snch  is  available  ;  the  contraction  of  the  muscles 
of  the  face,  the  dilated  nostrils  and  the  retracted  angle  of  the 
mouth  give  an  anxious  expression  to  the  countenance  ;  the  eyes 
are  semiclosed  ;  the  pulse  full  but  ^oi'i— {oppressed)— ,  beats  from 
48  to  70  per  minute  ;  the  bowels  are  slightly  costive,  the  urine 
scanty  and  high  colored  ;  the  skin  \\\^\2i<i'i\Q— hidebound— \\^xs\\ 
and  dry,  though  sweats  may  bedew  it  in  parts  ;  the  loins  insensi- 
ble to  pinching  ;  and  if  there  is  any  discharge  from  the  nose  it 
consists  only  in  a  reddish — rusty — colored  mucus. 

Auscultation  and  percussion  complete  the  diagnosis.  At  the 
outset  the  inflamed  portion  of  lung,  usually  near  its  lower  part, 
conveys  a  crepitating  sound  to  the  ear,  but  as  consolidation  ex- 
tends the  healthy  murmur  and  the  crepitating  rale  are  alike  sup- 
pressed over  the  whole  extent  of  the  hepatised  portion  around  the 
margin  of  which  a  line  of  crepitation  betrays  the  limit  of  the  ad- 
vancing inflammation.  A  similar  Hne  of  crepitation  encircles  th 
hepatised  mass  even  when  the  exuded  products  are  being  absorbed 
and  when  the  lung  is  being  cleared  up  and  restored  to  its  healthy 
state.  Thus  the  advance  of  the  inflammation,  and  the  progress 
of  recovery  can  be  equally  followed  by  the  crepitation  which,  in 
the  different  circumstances,  betokens  active  inflammation  or  active 
absorption.  When  both  lungs  are  involved  the  posterior  parts 
are  chiefly  implicated,  while  if  the  pneumonia  is  single  it  may 
attack  the  anterior,  median  or  posterior  part,  or  the  entire  lung  may 
become  consolidated.  If  hepatisation  exists  in  the  anterior  part 
of  the  lung  the  thick  fleshy  shoulder  will  forbid  any  satisfactory 
examination,  but  if  in  the  middle  portion  only,  while  the  respira- 
tory murmur  is  lost  it  will  be  replaced  by  a  strong  blowing  sound 
(bronchial  respiration)  because  the  noise  of  the  air  rushing 
through  the  larger  bronchial  tubes  to  the  posterior  healthy  part 
of  the  lung  is  conveyed  with  greater  force  to  the  ear  through  the 
consolidated  lung  tissue.  This  is  audible  from  the  lower  third  of 
the  chest  to  the  upper  limit  of  hepatization.  The  respiratory 
murmur  in  the  healthy  lung  is  always  louder  than  is  natural. 

Percussion  confirms  these  results.  Over  the  hepatised  lung 
where  no  respiratory  sound  remains,  a  dull,  dead  sound  only  is 
brought  out  by  the  impulse  of  the  fingers  or  closed  fist,  compar- 
able to  that  obtained  by  percussion  over  the  muscular  masses  of 
the  shoulder  or  haunch,  and  forming  a  marked  contrast  to  that 


Acute  Croupous  Pneumonia.     Pneumonitis  in  the  Horse.   221 

obtained  over  the  surrounding  healthy  lung.  There  is  not  that 
tenderness  on  pressure  in  the  intercostal  spaces  which  characterises 
pleuris}^  but  a  sharp  blow  with  the  closed  fist  leads  to  wincing 
and  usually  grunting  because  of  the  concussion  to  which  the 
diseased  part  is  subjected.  By  increasing  the  force  of  such  blows 
the  deepest  parts  of  the  lungs  may  be  tested,  since  in  this  way 
dullness  due  to  consolidation  of  the  deeper  portions  of  the  lungs 
may  be  detected  even  though  the  superficial  investing  parts  are 
healthy. 

The  nature  of  the  symptoms  will  vary  according  to  the  extent 
and  character  of  the  inflammation,  from  mild  febrile  reaction,  with 
excited  breathing  and  slight  crepitation,  to  the  more  severe 
varieties  in  which  the  intensity  of  the  symptoms  are  such  as  to 
threaten  suffocation. 

A  marked  feature  of  pneumonia  in  solipedes  is  that  the  patient 
obstinately  stands  in  one  position  and  never  lies  down  so  long  as 
the  severity  of  the  inflammation  lasts.  The  sharp  crest  on  the 
lower  border  of  his  breast  bone  compels  the  horse  to  lie  on  his 
side,  and  since  in  this  postion  the  whole  weight  of  the  body  has 
to  be  overcome  in  any  full  dilatation  of  the  chest,  he  cannot  retain 
the  recumbent  posture  when  any  serious  impediment  to  breathing 
exists.  Hence  it  is  that  the  fact  of  a  horse  suffering  from  pneumo- 
nia having  lain  down  and  remained  so  for  some  time  is  justly 
accepted  as  an  indication  of  improvement. 

Progress  and  7'estilts  of  the  disease.  The  general  symptoms 
above  noted,  remain  with  more  or  less  intensity  throughout.  After 
the  first  flush  of  heat,  on  the  occurrence  of  febrile  reaction,  the 
limbs  become  alternately  hot  and  cold,  and  in  this  the  general  sur- 
face partakes  to  a  less  extent. 

The  tendency  of  pneumonia  is  to  a  crisis  and  recovery.  Cer- 
tain days  have  been  supposed  to  be  critical  and  on  the  whole  the 
third,  seventh,  eleventh  and  fourteenth  are  those  on  which  a 
favorable  change  is  most  probable. 

Among  the  more  favorable  iiidications  are  the  manifest  abate- 
ment of  the  high  bodily  temperature  and  febrile  symptoms  gen- 
erally, the  increasing  ease  and  regularity  of  the  breathing,  the 
greater  force,  distinctness  and  slowness  of  the  pulse,  the  perma- 
nent return  of  warmth  to  the  limbs,  the  softer  and  more  elastic 
feeling  of  the  skin,  the  recovery  of  appetite,  and  above  all,  the 


222  Veterinary  Medicine. 

turning  of  the  nos2  from  the  open  window  or  the  retention  of  the 
recumbent  position  for  a  length  of  time.  These  symptoms  will 
become  more  patent  day  by  day,  and  the  absorption  of  the  effused 
products  and  the  clearing  up  of  the  lung  may  be  traced  by  the 
gradually  decreasing  area  of  dullness  and  of  the  circular  line  of 
crepitation  as  ascertained  by  percussion  and  auscultation. 

If  on  the  contrary  the  disease  takes  an  unfavorable  turn,  some 
such  signs  as  the  following  will  manifest  it  :  Increasing  rapidity 
and  embarrasment  of  the  breathing ;  smallness  and  indis- 
tinctness of  the  pulse,  which  is  increased  to  perhaps  lOo  beats 
per  minute  ;  tumultuous  heart's  action,  the  impulse  of  which  is 
strongly  felt  behind  the  left  elbow  ;  a  more  laborious  working  of 
the  flanks  ;  frequent  despondent  looking  toward  the  flanks ;  paw- 
ing wath  the  fore  feet,  lying  down,  and  as  suddenly  rising  again  ; 
permanent  coldness  of  the  extremities  ;  hanging  head  with  great 
dullness  and  despondency  of  expression  ;  dull,  .sunken,  lusterless 
eye ;  hanging  lower  lip  ;  leaden  hue  of  the  nasal  mucous  mem- 
brane ;  convulsive  twitching  of  the  muscles  of  the  .surface ; 
reeling  in  gait,  and  extension  of  the  crepitation  over  all  the  still 
pervious  lung. 

SuBACUTK  Pneumonia.  This  term  is  employed  to  designate 
that  subdued  or  milder  form  of  the  disease  which  sometimes 
arises  spontaneously  and  at  others  follows  the  acute. 

In  this  variety  the  characteristic  symptoms  may  be  much  less 
marked  and  the  disease  is  less  ea.sily  recognized.  There  is  some 
acceleration  and  quickness  of  pulse,  lifting  of  the  flanks  and  heat 
of  the  mouth  and  body  generally.  There  are  alternations  of  heat 
and  cold  of  the  surface  and  extremities,  a  rough,  unthrifty  coat, 
hidebound,  a  dull,  listless  moping  manner  and  the  same  symp- 
toms on  auscultation  and  percussion  as  in  the  acute  form. 

The  changes  take  place  slowly  but  the  disease  may  prove  ob- 
stinate and  is  often  followed  by  permanent  alterations  in  the  lungs. 
Rheumatic  affections  of  the  limbs,  inflammation  of  the  feet,  and 
other  diseases  frequently  supervene  during  the  course  of  this  form 
of  the  affection. 

The  terminations  of  pneumonia  are  : — by  death  ;  resolution 
with  absorption  of  exuded  products  : — splenisation  ;  abscess  ; 
gangrene  ;  permanent  consolidation  with  organization  of  ex- 
uded products.  The  disea.se  will  sometimes  lapse  into  the  chronic 
form. 


Acute  Croupous  Pneumonia.     Pneumonitis  in  the  Horse.   223 

Death  is  fortunately  the  least  frequent  issue.  It  may  follow  on 
rapidly  advancing  and  general  congestion  of  the  lung, — asphyxia  ; 
from  heart  failure,  the  overworked  organ  becoming  exhausted 
under  the  strain  of  forcing  the  blood  through  the  virtually  imper- 
vious lungs;  from  hyperthermia,  the  limit  of  bodily  temperature 
io8°F.  having  been  reached  or  exceeded  ;  or  from  collapse  and 
exhaustion. 

In  resolution  which  is  the  most  favorable  termination  the  fe- 
brile and  other  symptoms  subside  and  the  exudations  in  the  effused 
lung  undergo  a  process  of  liquefaction  and  absorption  until  neither 
auscultation,  nor  percussion  nor  even  the  examination  of  the  lung 
after  death  will  show  the  slightest  trace  of  the  pre-existent 
disease.  This  is  the  most  common  termination  in  single  pneu- 
monia in  the  horse. 

Splenisation  is  that  condition  of  lung  already  described  under 
the  head  of  pul^nonary  congestio7i,  and  if  affecting  both  lungs 
throughout,  necessarily  destroys  life  by  arresting  the  aeration  of 
the  blood. 

Abscess.  Diffuse  suppuration  is  very  common  in  the  stage  of 
gray  hepatization.  In  this  the  affected  lung  becomes  more  or  less 
extensively  infiltrated  with  pus  limited  by  no  distinct  membrane 
like  the  pus  of  an  abscess,  but  exuding  freely  from  the  cut  sur- 
face of  the  lung  or  escaping  from  its  interstices  when  it  is  pressed. 
It  is  preceded  and  in  its  early  stages  associated  with  the  formation 
of  granular  masses  and  corpuscles.  Its  existence  cannot  be  cer- 
tainly ascertained  though  it  may  be  surmised  when  after  hepatiza- 
tion of  a  portion  of  hxngo.  in ueous  rale,  a  sort  of  gurgling,  is  heard 
in  the  adjacent  bronchium  and  an  abundant  muco-purulent  dis- 
charge takes  place  from  the  nose.  It  threatens  extensive  destruc- 
tion of  lung  tissue. 

Circurnscribed  suppuration  or  abscess  is  infrequent  though  occa- 
sionally met  with  in  the  horse  and  ox.  In  this  case  the  excessive 
exudation  at  one  point  liquefies  and  the  surrounding  lymph  becom- 
ing organized  into  a  vascular  membrane  an  abscess  is  formed. 
This  may  burst  into  the  bronchial  tubes  and  be  discharged  by  the 
nose.  In  less  favorable  cases  it  makes  its  way  toward  the  pleural 
surface  and  opens  into  the  cavity  of  the  chest.  It  is  impo.ssible 
to  detect  the  existence  of  a  pulmonary  abscess  though  after  it  has 
burst  into  a  bronchial  tube  the  existence  of  the  cavity  may  be  as- 
certained by  the  amphoric  sound  heard  on  auscultation. 


224  Veterinary  Medicine. 

Animals  may  recover  from  such  pulmonary  suppurations  or  if 
they  are  too  extensive  the  consequent  depletion  may  induce  hec- 
tic and  death. 

Gangrene  of  the  lung  is  happily  rare  and  has  appeared  to  be 
connected  with  close,  foul  stables,  previous  ill  health,  and  work 
after  the  onset  of  pneumonia.  It  is  characterized  by  high  temper- 
ature (io5°  to  ioS°  F. )  by  great  dulnessand  prostration  due  to  the 
poisoning  of  the  nerve  centres,  by  weakness  and  unsteadiness,  by 
complete  loss  of  appetite,  and  at  length  an  intolerable  foetor  of  the 
breath  as  if  from  putrefying  animal  matter.  In  rare  cases  re- 
covery may  take  place,  the  dead  portion  having  become  detached 
and  expectorated. 

Consolidation  from  hepatization  is  the  condition  in  which 
the  inflamed  lung  is  always  found,  in  the  second  stage  of  the  dis- 
ease. The  lung  has  then  the  density  and  brownish  red  appear- 
ance naturally  belonging  to  the  liver  {red  hepatization),  which 
changes  on  the  occurrence  of  softening  of  the  exuded  products  to 
a  grayish  hue  {gray  hepatization) .  But  after  the  subsidence  of 
the  acute  symptoms,  the  process  of  liquefaction  and  absorption  is 
not  always  complete,  a  portion  of  the  exuded  product  becomes 
vascular,  is  developed  into  fibrous  tissue  and  remains  permanently 
impervious  to  air.  Such  is  the  state  of  the  lung  in  many  cases  of 
thick  or  short  wind  in  horses  when  these  have  occurred  as  a  sequel 
of  pneumonia.  A  horse  suffering  in  this  way  has  the  breathing 
habitually  accelerated  and  is  thrown  into  a  state  of  great  distress 
by  any  attempt  to  make  him  perform  hard  work  such  as  gallop- 
ing, dragging  a  load  up  hill  and  the  like.  A  chronic  cough  may 
equally  accompany  this  condition. 

Pathological  Lesions.  These  differ  according  to  the  stage  of 
the  disease.  In  \\\&  first  stage,  that  of  congestion  the  lung  tissue 
is  engorged  with  blood  as  described  under  the  head  of  congested 
lungs.  As  early  as  6  or  7  hours  after  artificial  irritation,  the 
alveoli  of  the  affected  part  are  already  filled  by  exudation  and  cell 
proliferation.  Until  this  has  taken  place  the  alveoli  can  still  be 
distended  by  blowing  into  the  bronchial  tube. 

In  the  second  stage  the  condition  of  the  lung  is  that  of  red 
hepatisation,  .so  called  from  its  resemblance  in  color  and  con- 
•sistency  to  the  liver.  There  are  gradations  between  congestion 
and  red  hepatisation.     In  the  earlier  stages  of  the  latter,  the  lung 


Acute  Croupous  Pnciunonia.     Pneumonitis  in  the  Horse.    225 

retains  a  measure  of  its  softness,  elasticity  and  permeability  to  air, 
though  it  is  considerably  firmer  and  less  permeable  than  that 
which  is  in  a  state  of  congestion  and  differs  further  from  it  in 
exuding  from  its  cut  surface  not  a  grumous,  dark  bloody  pulp, 
but  a  clear  straw  colored  fluid.  In  the  advanced  red  hepatisatioji 
the  lung  is  of  a  firm  consistency  and  granular  liver  like  appear- 
ance. In  color  it  varies  from  a  bright  red  to  a  dark  liver  hue, 
the  darker  shades  being  chiefly  met  with  in  old  animals  or  when 
the  inflammation  and  fever  have  been  intense  and  prostrating. 
Varying  shades  are  seen  in  different  lobules  of  the  same  lung. 
Its  air  cells  are  no  longer  pervious,  it  no  longer  crepitates  under 
the  pressure  of  the  finger,  nor  floats  in  water,  and  its  friability  is 
such  that  it  breaks  down  readily  when  the  finger  is  thrust  into  its 
substance.  Its  surface  is  distinctly  granular  from  the  fibrinous 
plugging  of  the  alveoli.  Such  a  lung  does  not  collapse  when  the 
chest  is  opened  but  retains  its  bulk  and  shape  and  in  some  cases 
the  diseased  portion  may,  by  reason  of  the  abundance  of  the  ex- 
udation, be  really  larger  than  the  same  portion  of  lung  in  a  normal 
state  of  dilatation.  Its  surface  may  thus  retain  the  imprint  of  the 
ribs.  Owing  to  the  stasis  of  the  blood  in  the  vessels  a  hepatised 
portion  of  lung  cannot  be  injected.  The  exudation  which  infil- 
trates the  lung  tissue  and  obliterates  the  air  cells  contains  in  the 
vicinity  of  the  bloodvessels  numerous  granular  masses  and  cor- 
puscles and  in  the  darker  colored  portions  blood  globules,  owing 
to  the  action  of  diapedesisofthe  red  cells  and  the  rupture  of  minute 
vessels.  The  smaller  bronchial  tubes  stand  out  white  and  empty 
showing  that  the}'-  have  escaped  the  inflammator}'  action.  He- 
patization usually  extends  from  the  anterior  lobe  or  lower  border 
upward. 

Gray  hepatization  is  a  sequel  of  the  r^^and  presents  the  same 
firmness,  friability  and  usually  the  same  granular  aspect ;  the 
lack  of  crepitation  on  pressure,  and  the  higher  density  than  water. 
From  the  cut  surface  a  fatty  or  purulent  fluid  exudes  spon- 
taneously, or  in  other  cases  only  when  pressure  is  applied.  The 
granular  masses  and  corpuscles  have  disappeared,  and  if  supura- 
tion  is  not  so  abundant  as  to  prove  extensively  destructive  to 
lung  tissue,  that  is  gradually  deared  up  and  restored  to  health. 
This  state  is  always  a  very  perilous  one. 

Abscess  of  the  lung  sometimes  met  with  in  animals  dying  of 
15 


226  Veterinary  Medicine. 

pneumonia  shows  a  circumscribed  area  of  inflammation  and  indu- 
ration with  the  Hquid  pus  in  the  centre  immediately  surrounded 
by  a  vascular  (limiting)  membrane.  Abscess  may  be  single  or 
multiple  though  in  the  latter  case  it  is  commonly  a  symptom  of 
pyaemia. 

In  gangrene  of  the  lung  the  part  may  be  in  the  dried  condition 
of  an  eschar  ;  it  may  indicate  gangrene  only  by  its  altered  color, 
its  flaccidity,  its  fetid  smell  and  the  altered  appearance  of  all  its 
microscopic  elements  ;  it  may  be  denoted  by  a  putrid  softening, 
the  tissue  easily  breaking  down  into  a  stinking  pulp  of  mixed  fi- 
brous and  granular  materials  ;  or  lastly  there  may  be  merely  a 
cavity  with  traces  of  putrid  contents,  the  dead  mass  having  been 
detached,  disintegrated  and  expectorated. 

Modifications  of  the  Blood  aiid  Distant  Organs. 

A  marked  feature  of  pneumonia  is  the  destruction  of  red  blood 
globules.  This  is  early  indicated  in  the  staining  of  the  visible 
mucosae  by  the  liberated  haemaglobin  and  by  actual  count  they  may 
be  reduced  in  the  horse  from  7,500,000  to  6,000,000  per  cubic 
millimeter  (Trashot).  There  is  an  increase  of  white  globules,  an 
absolute  increase,  not  only  in  ratio  to  the  red.  The  haematoblasts 
are  enormously  increased  especially  during  defervescence.  The 
fibrine  (fibrine  formers)  is  materially  increased  ;  in  the  horse  from 
3.5  to  6.7  or  7.5  per  1,000  (Grehaut).  Albumen  is  diminished. 
Soda  salts  are  increased.  The  bronchial  lymphatic  glands  are  al- 
ways congested,  swollen  and  reddened  with  some  serous  effusion. 
They  may  become  the  seat  of  inflammatory  cell  growth  (embry- 
onic tissue)  or  even  of  suppuration.  The  abscess  may  open  into 
the  bronchia  or  pleura.  These  are  especially  to  be  dreaded  from 
their  tendency  to  implicate  the  inferior  laryngeal  nerve  and  induce 
roaring. 

Pleurisy  is  inevitable  when  the  inflammation  reaches  the  sur- 
face of  the  lung,  hence  hydrothorax  is  often  present.  Pericardi- 
tis and  hydropericardium  are  similarly  met  with.  Endocarditis  is 
occasionally  present  and  may  be  traced  to  strain  of  the  valves  of 
the  laboring  heart,  or  to  direct  infection  with  the  pneumonia  mi- 
crobe. Dilatation  of  the  right  ventricle  is  common  as  a  result  of 
the  obstructed  pulmonary  circulation. 


Acute  Croupous  PncutnoJiia.     Pncicmonitis  in  the  Horse.   227 

Fatty  degeneration  of  the  heart  and  congestions  of  the  intes- 
tinal mucosa,  liver,  kidneys,  and  spleen  are  further  complications. 

Finally  larainitis  and  rheumatoid  affections  occur  as  complica- 
tions. 

Treatment.  This  must  be  adapted  to  the  nature  and  condition 
of  the  subject  and  to  the  character  of  the  disease.  A  horse  in 
vigorous  condition  or  with  an  acute  type  of  inflammation  may  be 
greatly  benefitted  by  an  actively  d2pleting  treatment,  whereas  to 
the  same  animal  in  a  low  state  of  health,  or  during  the  prevalence 
of  an  epidemic  form  of  the  malady  depletion  may  be  destruction. 
It  is  not  'Sought  here,  as  is  so  often  done  in  the  consideration  of 
this  disease,  to  ring  the  changes,  as  to  the  probability  of  a  change 
of  type  in  disease,  or  a  change  of  theory  on  the  part  of  physicians, 
having  affected  the  practice  of  bloodletting.  True  to  our  primary 
purpose  of  rendering  the  work  eminently  practical,  we  shall  first 
notice  the  general  management  applicable  to  all  ca.ses,  then  the 
treatment  of  the  two  great  types  of  the  disease,  acute  (sthenic), 
and  subacute  (asthenic),  leaving  to  the  enlightened  judgment  of 
the  reader  to  apply  an  appropriately  modified  system  to  that  large 
class  of  cases  which  occupy  an  intermediate  position. 

A  pure  airy  box  is  first  demanded,  with  the  windows  or  doors 
toward  the  south,  or  at  least  not  turned  in  the  direction  of  the 
prevailing  cold  winds.  The  craving  for  pure  air,  so  strikingly 
shown  by  the  position  which  the  animal  assumes,  ought  never  to 
be  ignored  nor  neglected.  We  do  not  advocate  the  system  of  the 
late  Professor  Coleman  who  kept  pneumonia  patients  in  open 
sheds  exposed  to  all  vicissitudes  of  temperature  winter  or  summer, 
and  yet  the  fact  that  many  recovered  under  such  treatment  as  well 
as  under  a  more  rigorous  system,  having  been  turned  out  into  the 
open  fields  amidst  frost  and  snow,  ought  to  open  the  eyes  of  all 
to  the  incomparable  value  of  fresh  air  in  this  disease.  The  box 
then  must  be  dry,  cool  and  airy  but  without  a  cold  exposure  and 
without  draughts  of  cold  air. 

Next  in  importance  to  pure,  cool  air  is  the  comfort  of  the  pa- 
tient. Any  tendency  to  chill,  shivering,  staring  coat,  or  coldness 
of  the  surface  and  extremities  is  to  be  counteracted  as  far  as  pos- 
sible. One  or  more  blankets  according  to  the  condition  of  the  pa- 
tient and  the  temperature  of  the  atmosphere  are  valuable  and  for 
the  same  reason  a  hood  may  be  put  on.     Coldness  of  the  limbs  is 


228  Veterinary  Medicine. 

to  be  met  by  active  rubbing  with  the  hand  or  with  wisps  of  drj' 
hay  and  then  wrapping  up  loosely  in  flannel  bandages.  Some  ap- 
ply to  the  limbs  ammonia  and  oil,  spirits  of  turpentine,  and  other 
stinmlants  and  thus  by  a  powerful  derivative  action  obtain  an  al- 
leviation of  the  lung  symptoms.  For  the  same  reason  a  mustard 
poultice  on  the  chest,  or  the  hot  wet  rugs  recommended  for  con- 
gested lungs,  often  prove  valuable  in  the  earlier  stages.  Large 
injections  of  warm  water  and  the  supply  of  warm  gruels  are  not 
to  be  neglected  when  they  can  be  employed.  Measures  such  as 
these  directed  to  check  any  chill  aud  render  the  circulation  free 
and  uniform  in  the  skin  and  extremities,  if  adopted  during  the 
cold  stages  of  the  fever,  will  sometimes  succeed  in  bringing  about 
a  resolution  of  the  pulmonary  congestion  and  warding  off  a  threat- 
ened attack  of  pneumonia. 

The  diet  should  be  of  a  non-stimulating  and  laxative  kind. 
Bran  mashes,  linseed,  oatmeal,  or  other  gruels,  carrots,  turnips, 
scalded  hay,  or  green  food,  if  at  the  proper  season,  should  be 
given  in  small  quantities  so  as  not  to  satiate. 

Antiphlogistic  Treatment.  Half  a  century  ago  bloodletting  was 
considered  the  remedy /ar  excellence  for  pneumonia  and  it  seemed 
justified  by  the  marked  relief  to  breathing  and  pulse  which 
usually  at  once  followed  a  free  bleeding.  In  a  short  time,  how- 
ever, the  fever  would  rise  anew  and  the  distressing  symptoms  re- 
appear, which  led  the  school  of  Broussais  to  repeat  the  bleeding, 
coup  sur  coup,  as  often  as  the  exacerbation  appeared.  There  was 
no  respite  for  either  age  or  condition,  the  debilitated  city  toiler, 
the  babe  at  the  breast,  and  man  of  eighty  tottering  into  the  grave 
had  alike  to  submit  to  the  lancet,  and  when  the  oppressive  symp- 
toms returned,  the  blood  had  to  flow  anew.  Broussais  himself, 
however,  recognized  his  error  in  his  later  life,  and  remarkably 
enough,  his  conversion  was  effected  through  veterinary  practice. 
His  two  carriage  horses  were  successively  attacked  by  pneumonia  : 
the  first  was  treated  by  bleeding  coup  sur  coup  and  recovered  :  the 
second  was  put  under  a  more  conservative  treatment  and  also  got 
well,  but  while  the  first  remained  soft,  flabby,  debilitated  and  sus- 
ceptible for  a  length  of  time,  the  second  was  on  convalescence  at 
once  able  to  go  into  active  work.  The  enormous  abuse  of  bleed- 
ing, led  to  its  more  complete  abandonment  than  would  otherwise 
have  been  probable,  and  the  contrast  between  the  high  mortality 


Acute  Croupous  Pneumonia.     Pneumonitis  in  the  Horse.   229 

of  cases  treated  by  excessive  bleeding,  and  the  lower  fatality  in 
pneumonias  treated  without  phlebotomy  on  the  expectant  (let 
alone)  plan  of  Dietl  or  the  stimulating  method  of  Todd,  Bennett 
and  others,  served  to  hasten  its  abandonment.  Yet  in  bloodletting 
we  have  an  instrument  for  good  or  evil  which  is  not  to  be  judged 
on  slight  evidence.  The  mere  lessening  of  the  blood  pressure  is 
to  be  little  considered,  as  it  requires  the  abstraction  of  nearly  one- 
third  of  the  entire  mass  of  blood  to  visibly  affect  this.  The  vas- 
cular walls  at  once  adapt  themselves  to  the  lessened  amount.  Nor 
is  the  mere  lessening  of  the  volume  a  vital  point.  After  moderate 
bleeding  this  is  made  up  in  a  few  hours  :  after  severe  bleeding  in 
24  to  /l8  hours.  The  loss  of  adult  red  globules  is  more  lasting. 
Bleeding  to  the  extent  of  one  per  cent,  of  the  body  weight  may 
have  the  number  restored  in  seven  days.  The  young  red  globules 
though  rapidly  produced  have  individually  less  haemoglobin,  and 
they  can  convey  less  oxygen  to  the  tissues.  This  should  mean 
less  oxidation,  less  heat,  less  waste,  less  urea,  uric  acid,  hippuric 
acid  and  other  poisonous  products  in  the  tissues.  Yet  Baur  says 
that  in  anaemia  there  is  a  greater  metabolism  of  proteids  and  more 
excretion  of  urea.  How  easy  it  is  to  blunder  in  looking  from  one 
single  point  of  view.  Again  after  bleeding  there  is  a  great  relative 
increase  of  the  various  forms  of  white  blood  globules,  most  of 
them  young  and  therefore  with  somewhat  altered  functions.  The 
paucity  of  red  globules  and  excess  of  white  are  brought  about  by 
the  pneumonia  and  independently  of  bleeding,  so  that  it  is  difficult 
to  say  whether  the  phlebotomist  is  enhancing  an  evil,  or  helping 
a  natural  therapeusis.  It  seems  hopeless  to  estimate  the  effects 
of  these  and  other  changes  in  the  blood  after  bleeding,  upon  th© 
metabolic  processes  of  nutrition,  secretion  and  sanguification, 
This  digression  has  not  been  made  to  ellucidate  the  results  or  the- 
modus  operandi  of  bleeding,  but  rather  to  illustrate  the  complexity- 
of  the  problem  involved  and  to  warn  against  broad  ^nd  unwar- 
ranted  generalizations  from  insufficient  premises. 

Even  to-day  practitioners  of  the  soundest  judgment  meet  with  a 
limited  number  of  cases  in  which  they  resort  to  bleeding  with  ad- 
vantage. These  occur  mainly  in  strong,  robus^  constitutions,  in 
individuals  accustomed  to  an  invigorating,  open  air  life,  liberal^ 
diet  and  abundant  exercise.  Ev^en  in  these  this  measure  is  chiefly - 
resorted   to,   to  relieve  an  acute  pulmouar-y  cppgestipn  with  ^, 


230  Veterinary  Medicine. 

dangerous  distension  and  over  charging  of  a  fatigued  and  over- 
worked heart.  In  short  the  condition  is  one  closely  allied  to  acute 
congestion  in  which  the  value  of  bleeding  is  all  but  universally 
admitted.  It  is  especially  warranted  early  in  the  disease,  though 
it  may  still  be  adopted  with  caution  in  a  similar  condition  which 
has  supervened  at  a  later  stage.  A  strong  pulse  and  bright  red 
mucous  membranes,  are  not  as  has  been  supposed,  essential  pre- 
requisites to  its  employment.  The  mucosae  may  be  pale,  or  more 
likel}'  cyanotic,  and  the  pulse  small  and  weak,  from  the  over 
charging  of  the  heart  and  its  tendency  to  failure,  and  it  is  to  re- 
lieve these  conditions  that  we  adopt  this  most  potent  of  all  meas- 
ures for. securing  a  temporary  lessening  of  the  blood  pressure  in 
the  right  heart  and  pulmonary  circulation.  Even  the  transient 
relief  may  allow  this  to  right  itself  and  then  less  radical  or  danger- 
ous measures  may  be  relied  on.  Bleeding  should  very  rarely  be 
resorted  to  save  at  the  outset  of  the  disease  ;  extensive  exudation 
into  the  lung  tissue  strongly  contra-indicates  it ;  it  cannot  be  safely 
employed  in  the  very  young  or  old,  in  weak  or  debilitated  sub- 
jects, when  the  pneumonia  has  relapsed  or  supervened  on  another 
serious  malady,  or  when  occurring  in  an  unhealthy  district.  Dela- 
fond  met  with  a  very  high  death-rate  from  bleeding  in  a  damp 
undrained  locality.  Where  bleeding  is  permissible,  the  blood 
should  be  drawn  from  the  jugular  in  a  full  stream,  from  a  large 
orifice,  the  finger  being  placed  upon  the  pulse,  and  the  flow 
arrested  as  soon  as  the  blood  is  felt  to  pass  along  the  vessel  in  a 
fuller,  freer  current,  and  the  breathing  is  seen  to  be  relieved.  It 
can  rarely  be  repeated  with  profit  or  safety,  and  in  the  vast  ma- 
jority of  cases  can  be  well  dispensed  with  altogether. 

Antipyretic  Treatment.  When  the  temperature  runs  danger- 
ously high,  a  temporary  use  of  antipyrin,  acetanilid,  phenacetin, 
or  other  potent  antithermic  remedy  may  be  resorted  to.  But 
agents  that  so  profoundly  affect  the  heat  centres  are  not  devoid  of 
danger  and  should  not  as  a  rule  be  continued  after  the  dangerous 
excess  of  temperature  has  been  overcome.  They  may  be  looked 
on  as  valuable  to  temporarily  obviate  an  extreme  danger  rather 
than  as  a  form  of  regular  treatment. 

The  modern  resort  of  applying  ice  bags  to  the  chest  may  be  sim- 
ilarly disposed  of.  In  very  high  fever  they  have  been  apparently 
beneficial,  but  the  danger  of  chill  or  injurious  reaction  is  so  great 


Acute  Croupous  Pneumonia.     Pneumonitis  in  the  Horse.   231 

that  they  must  bs  employed  with  the  greatest  possible  considera- 
tion and  care. 

Refrigerant  Febrifuge.  Neutral  salts  such  as  saltpeter  in  2 
drachm  doses  every  six  hours  may  be  given  in  the  drinking  water. 
Th2S2  are  valuable  for  their  cooling  and  eliminating  action,  and 
possibl}'  in  counteracting  the  viscidit}^  of  the  blood  and  exuda- 
tions. Acetate  of  potash,  bicarbonate  of  soda,  iodide  of  potas- 
sium or  muriate  of  ammonia  may  be  substituted. 

Stimjilants.  In  debilitated  subjects  or  with  low  fever  or  op- 
pressed heart  the  stimulating  diuretics  like  sweet  spirits  of  nitre 
or  liquor  of  the  acetate  of  ammonia  are  to  be  preferred,  and  this  is 
especially  the  case  during  convalescence.  They  at  once  sustain 
the  flagging  heart  and  aid  in  the  excretion  of  morbid  products. 
Digitalis  is  often  of  great  value  in  the  same  sen.se,  and  as  a  heart 
stimulant  nux  vomica. 

Some  follow  Todd  and  Bennett  in  seeking  stimulation  from  al- 
cohol, ammonia  and  its  salts,  ether,  etc.  When  the  circulation  is 
weak  or  flagging  these  are  often  of  value  and  they  may  even  act 
directly  on  the  pathogenic  microbe.  The  inhalation  of  oxygen, 
or  the  solution  of  proxide  of  hydrogen  given  by  the  mouth  has 
often  an  excellent  effect. 

Sedatives.  Aconite  has  become  too  much  of  a  domestic  remedy, 
nevertheless  it  may  be  used  with  advantage  in  high  fever  with  ex- 
cited heart  action,  to  moderate  the  circulation  and  relieve  the 
breathing.  Veratrum,  hydrobromic  acid,  bromide  of  sodium  or 
ammonium,  or  chloral  hydrate  may  be  used  as  alternates  or  sub- 
stitutes. 

Compresses.  Fomentations.  Poultices.  No  measure  is  safer 
nor  more  promising,  especially  in  the  early  stages,  than  the  poul- 
tice jacket  or  compress.  A  blanket  wrung  out  of  hot  water  is 
wrapped  around  the  chest,  covered  with  a  thick  dry  one,  and  held 
firmly  attached  by  elastic  circingles.  Or  soaked  cotton  wool  is 
applied  and  covered  with  a  dry  blanket  or  a  rubber  sheet.  The 
more  acute  the  inflammation  the  more  valuable  is  this  measure. 

Derivatives.  As  a  derivative  the  mustard  pulp  rubbed  in  and 
covered  with  thick  paper  or  rubber  is  especially  valuable.  In  one 
hour  it  may  secure  a  free  exudation  and  material  relief  to  the 
breathing.  It  may  be  replaced  b}^  ammonia  and  oil,  with  or  with- 
out a  covering,  by  hot  water  or  b}-  cantharides.     This  must  how- 


232  Vderhiary  Medicine. 

ever  ba  used  with  judgment.  In  the  early  stage  with  a  high 
tj'pe  of  inflammation  and  fever  the  surface  irritation  ma}^  aggra- 
vate this  through  sympathy  ;  in  such  cases  therefore  the  severity  of 
the  inflammation  should  first  be  moderated  before  using  an  active 
counterirritant.  In  debilitated  conditions,  too  with  an  altered  or 
depraved  state  of  the  blood  and  during  the  prevalence  of  a  low 
type  of  the  disease,  sloughing  may  ensue  from  incautious  blister- 
ing; 

The  repetition  of  the  blister  is  often  useful,  the  healing  process 
going  on  simultaneously  in  the  blistered  surface  and  the  dis- 
eased lung  by  virtue  of  nervous  sympathy. 

To  complete  recovery  a  course  of  vegetable  tonics,  such  as  gen- 
tian, nux  vomica,  calumba,  may  be  given  with  iodide  of  potass- 
ium for  a  week  or  more.  Constipation  occurring  during  conva- 
lescence must  always  be  corrected  by  food,  (bran  mashes,  linseed 
gruel),  injections,  or  oleaginous,  saline,  or  aloetic  laxatives.  The 
greatest  care  should  be  exercised  to  secure  pure  air,  comfort,  sun- 
shine, good  grooming  and  general  hygiene,  and  to  prevent  over- 
exertion during  convalescence. 

In  the  subacute  types  of  pneumonia  the  fundamental  difference 
in  the  treatment  consists  in  the  avoidance  of  all  depressing  reme- 
dies and  the  employment  of  stimulants  and  a  supporting  diet  from 
the  beginning.  Sweet  spirits  of  nitre  and  liquor  of  the  acetate  of 
ammonia,  carbonate  of  ammonia  or  salammoniac  with  digitalis 
and  strychnia  may  be  used  from  the  first.  Vegetable  tonics  may 
be  resorted  to  at  an  early  stage,  peroxide  of  hydrogen,  and  when 
expectoration  is  established  and  the  fever  moderated  even  mineral 
tonics  may  be  employed.  Nourishing  gruels,  mashes,  roots, 
green  food,  and  scalded  oats  may  be  used  in  turn  to  coax  the  ap- 
petite and  not  to  satiate.  In  other  respects  the  treatment  is  the 
same  as  for  the  acute.  This  form  of  the  disease  is  liable  to  prove 
obstinate  and  persistent,  and  there  appears  to  be  a  greater  tenden- 
cy to  complications  and  so  called  metastasis,  as  enteritis,  laminitis 
or  rheumatoid  affections  of  the  back  or  limbs.  These  when  they 
occur  must  be  treated  as  if  they  had  arisen  in  ordinary  circum- 
stances, having  regard  meanwhile  to  the  remaining  inflammation 
in  the  lungs,  for  that  has  not  necessarily  been  quite  superseded  but 
only  alleviated. 

Chronic  Pneumonia.     This  has  been  described  but  if  uncom- 


Croupous  Pncicmonia  in  the   Ox.  233 

plicated  by  consumption  it  appears  to  be  usually  only  that  consolida- 
tion of  lung,  due  to  the  organization  of  exuded  products  into  fibrous 
tissue,  which  occasionally  forms  a  sequel  of  acute  inflammation  of 
the  lungs.  In  such  cases  an  access  of  circumscribed  local  conges- 
tion is  liable  to  result  from  overexertion,  or  a  chronic  state  of  ir- 
ritation is  maintained  attended  with  more  or  less  fever,  inappetence, 
mal-assimilation,  and  often  in  the  long  run  hectic,  under  which  the 
animal  is  worn  out.  In  such  cases  the  chief  indications  are  to 
avoid  overwork  or  any  undue  strain  upon  the  breathing  organs,  to 
support  the  patient  by  nourishing  and  easily  digested  food,  and  to 
control  and  remove  any  local  irritation  by  measures  indicated  under 
the  head  of  acute  pneumonia. 


CROUPOUS  PNEUMONIA  IN  THE  OX. 

Subacute  in  many  cases.  Effect  of  temperament,  and  work.  Acute  form. 
Symptoms.  Decubitus.  Unfavorable  symptoms.  Prognosis.  Suppura- 
tion frequent  :  indications.  Gangrene.  Coliquative  Diarrhoea.  Lesions, 
Comparison  with  those  of  lung  plague.  Tubercle.  Treatment,  bleeding, 
laxatives,  refrigerant  salts,  derivatives,  stimulants,  tonics.  Chronic  form. 
Symptoms.     Treatment. 

In  the  large  ruminants  this  disease  tends  more  towards  a  sub- 
acute type  than  in  the  horse,  and  coming  on  insidiously  from  or- 
dinary causes  is  liable  to  be  confounded  with  the  contagioics  pleii- 
ro-p7ieumoiiia  of  the  bovine  race.  As  in  the  horse  the  nervous 
animals  show  more  violent  symptoms.  It  is  rare  in  milch  cows 
and  young  cattle  and  more  frequent  in  w^ork  oxen. 

In  the  acute  form  the  symptoms  mainly  agree  with  those  of  the 
horse.  There  is  the  same  shivering,  followed  by  a  hot  stage,  hy- 
perthermia, the  accelerated  pulse,  the  short  quick  labored  breath- 
ing, heaving  flanks,  cough  frequent,  deep,  hacking,  and  easily  ex- 
cited, dilating  nostrils,  redness  of  the  mucous  membrane,  and 
the  same  indications  on  auscultation  and  percussion,  care  be- 
ing taken  to  obviate  misconception  of  natural  conditions  in  the 
chest  of  the  ox.  There  is  in  addition  a  dry  muzzle,  tenderness  of 
the  back  and  breast  bones  and  wincing  when  they  are  pinched  be- 
tween the  fingers  and  thumb  ;  suspension  of  the  appetite  and  rum- 
ination and  in  cows  suppression  of  the  secretion  of  milk  ;  the  mouth 
is  often  opened  and  the  tongue  protruded  to  facilitate  breathing, 


234  Veterinary  Mediciyie. 

and  in  bad  cases  each  expiration  is  accompanied  by  a  moan  or 
grunt.  In  many  cases  the  ox  can  He  on  his  flattened  breast-bone 
and  maintain  the  breathing  process,  but  when  the  disease  is  severe 
he  stands  no  less  obstinately  than  the  horse,  his  elbows  turned  out, 
his  nose  protruded  and  directed  towards  a  window  or  other  open- 
ing. 

Among  the  unfavorable  symptoms  may  be  mentioned  increas- 
ing anxiet}'  and  distress,  a  more  oppressed  breathing,  the  animal 
standing  constantly  in  one  position  with  legs  apart,  elbows  turned 
out,  his  nose  extremely  raised,  nostrils  widely  dilating,  mouth 
open,  tongue  protruded,  the  expiratory  grunt  deep  and  prolonged, 
the  cough  infrequent  and  so  weak  as  to  be  almost  inaudible,  be- 
ing rather  like  a  forced  expiration,  and  the  pulse  rapid,  feeble  or 
imperceptible.  The  prognosis  is  favorable  in  moderate  cases  sub- 
jected to  early  treatment. 

The  termination  b}^  suppziratioii  is  more  frequent  than  in  the 
horse.  The  general  symptoms  are  ameliorated,  appetite  and  rum- 
ination return  though  they  remain  capricious  and  irregular,  there 
remains  the  double  action  of  the  flanks,  the  dry,  rough  muzzle, 
the  tense,  inelastic  skin,  frequently  varying  in  temperature,  the 
beast  shivers  at  intervals,  the  cough  is  weak  and  often  repeated,  a 
yellowish  thick  discharge  takes  place  from  the  nose,  weakness  and 
emaciation  increa.ses  and  the  animal  dies  in  from  twenty  to  thirty 
days. 

Gangrene  of  the  lung  sometimes  supervenes  and  is  indicated  by 
similar  symptoms  as  in  the  horse.  In  severe  and  prolonged  cases 
a  violent  fetid  diarrhoea  often  supervenes  and  hastens  a  fatal  re- 
sult. 

The  post  mortem  lesions  are  similar  to  those  of  the  horse. 
The  cut  surface  of  the  hepatized  lung,  however,  is  divided 
into  irregular  red  spaces  by  intersecting  yellow  lines — hence 
the  name  of  marbled  lung,  from  a  supposed  resemblance  to 
that  stone.  The  red  spaces  represent  the  pulmonary  lobules  and 
the  whitish  lines  the  surrounding  areolar  tissue  which  b^ing 
especially  abundant  in  ruminants  and  pigs  stands  out  prominently 
when  infiltrated  with  the  yellowish  exudation.  There  is  then 
nothing  specific  in  this  appearance  as  has  been  erroneously  sup- 
posed, it  is  merely  the  result  of  the  different  conformation  of  the 
lung  in  these  animals  and  is  always  seen  in  the  hepatized  lung 
unless  when  from  extravasation  of  blood  into  its  substance  the 


Crottpojis  Pneumonia  in  the  Ox.  235 

redness  is  rendered  uniform.  The  amount  of  exudate  into  the 
interlobular  tissue  is,  however,  never  so  great  as  in  lung  plague. 

The  greater  frequency  of  suppuration  in  the  lung  of  the  ox,  as 
well  as  the  greater  tendenc}^  to  tubercular  deposit  in  prolonged 
cases  are  additional  features  in  the  diseased  lungs. 

Treatment.  Blood-letting  should  be  employed  only  with  pre- 
cautions, as  in  the  horse.  A  saline  laxative  (i  lb.  Epsom  salts 
and  Yz  lb.  molasses)  may  be  used  with  advantage  and  safety  early 
in  the  disease  though  in  advanced  stages  it  may  sometimes  prove 
dangerous  from  the  tendency  to  diarrhoea.  If  constipation  appears 
at  a  late  stage  injections  of  warm  water  and  a  mild  laxative  (6 
ounces  sulphate  of  soda)  only,  should  be  given.  The  purgative 
may  be  followed  by  the  same  neutral  salts  and  in  the  same  doses 
as  for  the  horse.  Counterirritants  are  of  equal  value.  A  mustard 
poultice  may  be  kept  on  for  several  hours,  or  a  mixture  in  equal 
parts  of  oil  of  turpentine,  ammonia,  and  olive  oil  may  be  actively 
rubbed  over  both  sides  of  the  chest  and  repeated  daily  until 
tender.  In  Denmark  a  prompt  and  efficient  blister  is  made  with 
I  part  of  Croton  oil  and  10  parts  each  of  sulphuric  ether  and 
spirits  of  wine.  This  is  rubbed  actively  over  the  chest  and 
washed  off  as  soon  as  a  sufficient  effect  has  been  produced.  It 
must  be  carefully  watched  to  prevent  blemishing. 

In  the  low  types  of  the  disease  and  during  convalescence  stimu- 
lants and  tonics  are  to  be  employed  as  recommended  for  the  horse. 

Chronic  Pneumonia.  Gelle  describes  a  chronic  form  of  this 
disease  in  cows.  For  about  a  month  the  patient  became  increas- 
ingly emaciated,  there  was  a  frequent,  dry,  weak  cough,  lifting  of 
the  flanks,  and  expiration  double  and  accompanied  by  a  moan. 
All  these  symptoms  w^ere  aggravated  by  gentle  exercise.  Percus- 
sion detected  dullness  at  the  lower  part  of  the  lung  and  ausculta- 
tion a  distinct  crepitating  rale.  The  pulse  was  weak  and  rapid, 
the  mucous  membranes  red  and  tumid,  skin  dry,  ears  and  horns 
cold,  appetite  small  and  capricious,  rumination  rare,  excrements 
soft,  and  milk  almost  dried  up. 

The  treatment  is  by  diuretics  with  vegetable  tonics  and  stimu- 
lants and  active  counterirritation  over  the  chest.  Gelle  considers 
the  malady  as  all  but  incurable  unless  active  blistering  is  promptly 
employed  so  soon  as  the  malady  has  assumed  the  chronic  form 
and  before  extensive  structural  changes  have  taken  place  in  the 
lungs. 


CROUPOUS  PNEUMONIA  IN  SHEEP. 

Causes,  damp,  cold  soils,  inclement  weather,  cold  rains,  hard  driving, 
shearing  or  washing  in  cold  weather,  change  to  a  cold  climate,  or  from  a 
warm  barn,  hot  barns,  heavy  fleeces,  sudden  plethora.  Symptoms,  in  con- 
gestive cases,  in  inflammatory.  Treatment,  preventive,  hygienic,  anti- 
phlogistic, laxative,  febrifuge,  derivative. 

This  disease  is  not  uiifrequent  in  these  animals,  occurring  en- 
zootically  in  low,  wet  pastures  ;  or  from  cold  storms  of  wind,  sleet 
or  drenching  rains,  particularly  after  hard  driving,  or  shearing  ; 
or  from  washing  during  inclement  weather.  Dressing  with  mer- 
curial ointment  in  cases  of  scab  is  a  frequent  cause  of  pneumonia 
and  death  in  Lincolnshire  and  various  other  English  counties. 
Lastly  M.  Seron  in  Hurtrel  d'  Arboval's  "  Didionaire'"  describes 
its  prevalence  in  Seine- Infer iezire  among  low  conditioned  sheep 
subjected  abruptly  to  a  very  nutritious  diet.  The  hot  buildings, 
heavy  fleeces,  and  sudden  plethora,  appear  to  conduce  to  danger- 
ous pulmonary  congestions.  The  symptoms  do  not  differ  materi- 
ally from  those  seen  in  the  ox  except  so  far  as  they  are  modified 
by  the  fact  that  the  disease  often  terminates  fatally  before  hepa- 
tization has  been  established  and  the  symptoms  and  post  mortem 
appearances  are  those  of  congestion  and  sanguineous  engorgment 
of  the  lung  rather  than  of  hepatization. 

This  engorged  state  of  the  lungs  it  is  which  has  led  Youatt  and 
others  to  describe  them  erroneously  as  ' '  gangrenous ' '  and 
shepherds  to  name  the  disease  ' '  rot  of  the  lights. ' '  The  condi- 
tion is  that  of  acute  congestion  and  analogous  to  that  seen  in  con- 
gested lungs  in  the  horse. 

The  treatment  ought  to  be  chiefly  preventive  and  will  consist  in 
the  avoidance  of  the  causes  above  indicated. 

When  the  disease  has  set  in,  fresh  air,  and  general  comfort, 
bleeding  if  in  the  very  earliest  stages  and  in  a  strong  patient, 
purging  (3  ounces  sulphate  of  soda  and  yi^  lb.  treacle  in  warm 
gruel)  and  a  free  supply  of  nitre  (about  ^  an  ounce  daily  to 
each)  in  the  water  or  gruel  supplied  are  the  leading  indications.  As 
a  counterirritant  aqua  ammonia  acts  well  being  sufficiently  con- 
confined  by  the  fleece. 

236 


PIG.     PNEUMONIA. 

Symptoms,  chill,  burrowing,  hot  skin,  congh,  disturbed  breathing,  indica- 
tions of  exudation.  Treatment,  laxative,  sedative,  nauseant,  febrifuge,  wet 
jacket,  blister. 

Hogs  are  not  exempt  from  this  disease.  They  show  the  same 
symptoms  of  chill  with  hiding  under  the  litter,  followed  by  a  hot 
stage,  cough,  hurried  breathing,  and  (if  the  clothing  of  fat  is  not 
too  thick)  conclusive  results  on  auscultation  and  percussion. 

As  treatment  bleeding  from  the  ears  and  tail  is  .sometimes  re- 
sorted to  with  questionable  benefit,  A  laxative  of  three  ounces  of 
castor  oil  or  three  or  fourcroton  beans  given  in  the  food  is  of  value. 
Tartar  emetic  in  doses  of  }{  grain  and  nitrate  of  potash  in  lo 
grain  doses  .should  be  shaken  on  the  tongue  at  least  four  times 
daily  to  keep  up  a  continued  nausea  and  action  on  the  urinary  or- 
gans. The  tartar  emetic  so  worthless  in  the  larger  animals  is  of 
value  in  the  pig  and  dog.  A  damp  compress  or  bli.ster  may  be 
used.  The  skin  of  the  animal  is  difficult  to  blister,  but  by  the  use 
of  the  Danish  croton  liniment,  mentioned  for  the  ox,  of  hot  wa- 
ter, or  of  a  mixture  of  oil  of  turpentine  and  croton,  8  parts  of  the 
former  and  i  part  of  the  latter,  a  sufficient  effect  can  usually  be 
obtained. 


DOG.     PNEUMONIA. 


Breeds  most  liable.  Causes,  overexertion,  cold  baths,  clipping,  exposure 
in  cold,  distemper.  Symptoms,  chill,  fever,  disturbed  breathing,  cold  ex- 
tremities, cough.  Treatment,  dietary,  nursing,  laxative,  nauseant,  febrifuge, 
moist  jacket,  mustard,  stimulants,  tonics,  heart  tonics  and  careful  nutriti- 
tion  during  convalescence. 

Pneumonia  in  birds.  Causes,  exposure,  neglect,  foul  coops,  hot,  close 
houses,  etc.  Symptoms,  erect  plumage,  drooping  head,  wings,  and  tail, 
dark  comb,  gaping,  panting,  cough,  crepitation.  Treatment,  hygienic,  lax- 
ative, febrifuge. 

This  is  a  frequent  affection  in  hounds.  In  hunting  or  cours- 
ing dogs  the  causes  are  like  those  operating  in   the  horse.     The 

237 


238  Veterinary  Medicine. 

clipping  of  long  haired  dogs  in  inclement  weather,  swimming 
dogs  in  winter  without  afterwards  drying  or  heating  them  by  ex- 
ercise, and  shutting  them  out  of  doors  at  night,  when  accustomed 
to  a  warm  dwelling  are  occasional  causes.  It  sometimes  occurs 
epizootically  and  frequently  supervenes  during  distemper. 

The  chief  symptoms  of  chill,  fever,  and  difficulty  in  breathing 
are  like  as  in  other  animals,  while  the  results  of  auscultation  and 
percussion  are  more  satisfactory  than  in  any  other  domestic  ani- 
mal. The  dog  sits  on  its  haunches  to  facilitate  breathing  ;  his  el- 
bows turned  out,  his  mouth  .open  and  his  tongue  protruded. 
Coldness  of  the  ears  and  a  short  quick  cough  are  usually  marked 
.symptoms. 

Treatment.  The  general  care  applicable  to  other  animals  is 
equally  demanded  here.  The  diet  should  consist  of  mild  broths, 
or  farinaceous  foods  with  a  little  gravy  if  necessary  to  render  it 
palatable. 

Bleeding  from  the  jugular  has  been  recommended  and  may  be 
admissible  at  the  outset  of  the  disease  in  a  very  few  appropriate 
cases.  If  costiveness  exists  a  tablespoonful  of  castor  oil  may  be 
given  (more  or  less  according  to  the  size  of  the  animal),  following 
this  up  by  the  tartar  emetic,  nitre  and  .sugar  recommended  for 
bronchitis.  The  poultice  jacket  is  of  great  value.  Mustard  poul- 
tices may  later  be  applied  to  the  sides  of  the  chest.  Stimulants, 
tonics  and  nourishing  diet  may  be  required  during  convalescence, 
or  when  the  disease  assumes  a  low  type. 

CROUPOUS  PNEUMONIA  IN  FOWLS. 

In  chickens  exposure  and  neglect  are  alleged  causes.  Foul 
coops  and  the  contrast  between  the  warm  building  and  cold  outer 
air  are  justly  blamed.  Ruffled  feathers,  drooping  head,  dark  col- 
ored comb  and  wattles,  trailing  wings,  a  disposition  to  gape,  pant- 
ing and  cough  are  noticed.  Under  the  wings  and  over  the  back 
crepitations  and  dulness  may  be  detected.  The  patient  may  take 
a  teaspoonful  of  castor  oil,  and  saltpetre  or  iodide  of  potassium 
may  be  given  in  the  drinking  water.  In  careful  doses  the  other 
remedial  measures  may  be  attempted. 


ACUTE  PLEURISY  IN  THE  HORSE.     PLEURITIS. 

Causes,  cold,  damp,  soils  and  exposures,  as  with  rheumatism,  youth,  vigor, 
heavy  diet,  digestion,  or  hepatic  disorder,  overexertion,  perspiration  and 
succeeding  chill,  wading  or  swimming  rivers,  standing  in  snow,  salted  snow, 
rain,  sleet,  snow,  draughts  between  open  doors  and  windows,  clipping,  cold 
sponging  of  legs,  tuberculosis,  a  common  cause  in  man  and  cattle  is  rare  in 
horses,  surface  pneumonias,  cancers,  actinomycosis,  tumors.  Traumas  from 
broken  rib,  penetrating  intercostal  wound,  blows,  contusions,  ruptured  pul- 
monary or  intercostal  abscess.  Irritant  (  infectious  )  exudate  suggests  mi- 
crobes. Symptoms,  chill,  reaction,  partial  sweats,  pawing,  pointing  one 
foot,  hyperthermia,  hard,  jarring  pulse,  hurried  breathing,  inspiration  catch- 
ing, pleuritic  ridge,  uneasy  movements,  hacking  cough,  tumors  and  twitch- 
ing of  chest  muscles,  tender  intercostals,  grunting,  friction  sound,  subsiding 
with  appearance  of  dull  area  below,  signs  of  effusion,  relief,  dyspnoea,  lift- 
ing flanks  and  loins,  perspirations,  stocking  limbs,  pasty  swelling  on  ster- 
num, effusion  of  same  level  on  both  sieles,  creaking  sounds,-  splashing,  gur- 
gling, metallic  tinkling,  weakness,  sinking.  Signs  of  adhesions,  compres- 
sion of  lung,  abscess.  Duration.  Lesions,  early  formation  of  false  mem- 
branes, pleuritic  effusion,  its  composition,  its  color  at  different  stages,  dry 
pleurisy,  serofibrinous,  sero-fibro-purulent.  hydro-pneumothorax,  tubercle. 
Prognosis.  Treatment,  during  the  chill,  warm  air,  clothing,  drinks,  injec- 
tions, compresses,  pilocarpin  during  early  inflammatory  stage,  derivatives, 
dry  cupping,  mustard,  cantharides,  hot  water,  or  air,  cold  applications,  lax- 
atives, calmatives,  anti-rheumatics,  alkaline  agents,  with  bitters,  diuretics, 
heart  tonic,  iodine,  mercury,  thoracentesis. 

Causes.  Pleurisy  is  common  in  all  domestic  animals  and  es- 
pecially so  in  cold,  damp,  exposed  localities  which  suffer  equally 
from  rheumatism.  It  occa.sionally  extends  to  the  fascia  of  the 
limbs,  the  joints,  or  the  navicular  or  other  trochlea  as  a  rheu- 
matic affection.  The  disea.se  is  prevalent  among  young  and  vig- 
orous horses,  four  or  five  years  old,  on  stimulating  feeding. 
Here  hepatic  derangements  and  poisons,  over-exertion,  perspira- 
tion and  succeeding  chills  are  especially  to  be  .suspected.  Plung- 
ing the  limbs  in  ice  cold  water  as  in  wading  a  river  (Fromage), 
standing  in  snow  and  above  all  in  salted  snow,  or  facing  a  cold 
rain,  sleet,  or  snow  when  perspiring  or  fatigued,  are  recognized 
causes.  A  full  drink  of  ice  cold  water  when  freely  perspiring, 
and  followed  by  .standing  in  the  fro.sty  air,  or  in  a  cold  current  in- 
doors.    Exposure  unblanketed  after  clipping  in  winter    (Field, 

239 


240  Veterinary  Medicine. 

Trasbot),  and  even  sponging  the  bod 3^  or  legs  with  cold  water 
when  heated  or  fatigued  or  both.  St.  Cyr  found  that  pneumonias 
stood  to  pleuri.sies  as  3  :  i ,  Trashbot  as  10  :  i ,  yet  the  latter  draws 
attention  to  the  fact  that  in  cavalry  horses  habituated  to  the  stable 
and  sent  out  into  camps  in  the  depth  of  winter,  the  pleurisies  are 
more  numerous  than  pneumonias.  This  may  suffice  to  show  the 
importance  of  the  role  filled  by  cold  and  chill  in  the  production  of 
pleuris)'.  Yet  many  physicians  look  upon  the  chill  as  a  predispo- 
sition only,  while  the  true  origin  of  disease  is  microbian.  And  in 
man  a  large  proportion  of  pleurisies  appear  to  be  distinctly  tuber- 
culous. Bowditch  traced  90  cases  of  acute  pleurisy  and  found  that 
32  had  tuberculosis.  The  objection  to  generalizing  too  largely  on 
this  for  the  lower  animals  is  that  the  horse  and  dog,  in  which  tu- 
berculosis is  rare,  are  by  far  the  most  common  subjects  of  pleurisy, 
whilst  cows  which  are  very  prone  to  tuberculosis  show  few  cases 
of  simple  pleurisy.  Again  we  find  pleurisy  in  the  horse  as  the  re- 
sult of  other  diseases  localized  in  or  adjacent  to  the  pleura,  and 
where  there  is  nothing  to  indicate  tuberculosis.  Thus  it  follows 
pneumonia  approaching  the  surface  of  the  lung,  cancers,  actino- 
mycosis and  other  tumors,  and  traumas— a  pulmonary  abscess 
bursting  into  the  pleura,  a  broken  rib  scratching  and  lacerating 
the  lung,  a  perforating  wound  of  the  intercostal  space,  or  in  cattle 
a  sharp  pointed  body  advancing  from  the  reticulum  toward  the 
heart. 

But  the  presumptive  absence  of  the  tubercle  bacillus  in  the 
great  majority  of  pleurisies  in  the  horse  does  not  prove  the  absence 
of  all  pathogenic  microbes.  Trasbot,  who  rejects  the  microbian 
theory,  found  that  the  injection  of  a  little  of  the  exudate  into  the 
pleural  cavity  of  a  sound  horse,  always  determined  a  generalized 
pleurisy.  Injections  of  distilled  water  with  the  same  antiseptic 
precautions,  made  separately  by  himself  and  lyaborde,  had  no 
pathogenic  effect.  Trasbot  attributes  the  pleurisy  vaguely,  to  the 
irritant  effect  of  the  exudate,  but  if  it  should  finally  be  shown  that 
this  exudate  contains  microbes,  though  they  may  not  be  those  of 
tuberculosis,  the  irritant  action  will  be  much  more  clearly  ex- 
plained. There  are  forms  of  pleurisy  which  are  unquestionably 
the  result  of  microbes,  as  in  lung  plague,  influenza,  canine  dis- 
temper, glanders,  tuberculosis,  pneumo-enteritis,  actinomycosis, 
and  theoretically  it  might  be  supposed  that  in  our  ordinary  acute 


Acute  Pleurisy  in  the  Horse.     Pleuritis.  241 

pleurisies,  other  germs  that  have  been  lurking  harmless  in  the 
sj'stem  may  take  occasion  by  reason  of  the  lowered  vitality  in- 
duced by  a  chill,  or  a  trauma,  to  colonize  the  thoracic  serosa  and 
develop  pleurisy.  Under  such  a  theory,  the  predisposing  and 
microbian  element  would  remain  equally  effectual,  but  only  oper- 
ative when  conjoined,  neither  being  pathogenic  without  the  other. 

Until  the  constancy  of  the  microbian  factor  is  demonstrated  we 
must  recognize  the  time  honored  doctrine,  that  pleurisy  may  be 
due  to  cold,  exposure,  over  exertions,  to  traumatic  injuries,  blows, 
concussions,  fractures,  penetrating  wounds,  and  to  extension  by 
contiguity  from  adjacent  diseases. 

Most  commonly  pleurisy  is  unilateral  on  the  right  side  but  is 
often  on  the  left  or  on  both  stdes. 

Symptoms.  There  is  the  early  symptom  of  shivering  followed 
by  a  hot  .stage  in  which  the  limbs  participate  and  partial  .sweats 
bedew  the  surface.  There  are  first  uneasy  movements  of  the  fore 
limbs  with  some  lifting  of  the  flanks  and  this  discomfort  increases 
until  the  patient  is  panting  with  pain  and  occasionally  glancing 
round  at  his  heaving  flanks  and  even  pawing  as  in  colic.  If  the 
pleurisy  is  confined  to  one  side  the  corresponding  fore  limb  is 
often  advanced  before  the  other.  The  temperature  is  102°  and 
upward.  The  pulse  is  quick,  hard  and  incompressible  being 
usually  compared  to  a  jarred  wire  and  beats  from  48  to  over  60 
per  minute.  The  breathing  is  highly  characteristic.  It  is  hurried, 
is  carried  on  chiefly  by  the  abdominal  muscles  to  avoid  the  rubbing 
of  the  inflamed  pleurae  on  each  other,  and  has  the  inspiration 
short  and  suddenh^  checked  by  an  audible  closure  of  the  glottis 
while  the  expiration  is  .slow  and  prolonged.  This  character  of 
the  breathing  is  well  observed  when  the  ear  is  placed  against  the 
false  nostril.  The  laboring  abdominal  muscles  stand  out  as  a 
ridge  from  the  outer  angle  of  the  ilium  along  the  lower  ends  of 
the  last  ribs  (pleuritic  ridge).  A  tremor  on  this  line  is  often 
noticeable  in  the  early  stages.  It  may  also  be  felt  by  the  hand 
laid  on  the  costal  region.  The  horse  does  not  stand  obstinately 
still  as  in  pneumonia,  but  frequently  moves  as  if  seeking  an  easier 
posture.  The  short,  hacking  cough  contrasts  with  the  deep,  rare 
cough  of  pneumonia.  The  expired  air  is  not  so  hot,  nor  the 
mucous  membrane  of  the  no.se  so  red  as  in  the  last  named  disease 
and  there  is  no  nasal  discharge.     A  twitching  of  the  muscles  of 


242  Veterinary  Medicine. 

the  chest  is  sometimes  seen  and  if  the  intercostal  muscles  are 
pressed  upon,  the  animal  winces  and  frequenth-  grunts.  This  last 
symptom  is  likewise  seen  in  rheumatic  disease  of  the  intercostal 
muscles  (pleurodynia)  but  the  absence  of  the  fever,  the  cough, 
and  other  chest  symptoms  sufficiently  distinguish  this.  Ausculta- 
tion detects  in  the  early  stages  in  addition  to  a  healthy  respiratory 
murmur,  a  friction  sound  audible  in  inspiration  only  in  short  jerks 
near  the  close  of  the  act  and  comparable  to  the  rubbing  of  the 
palm  of  one  hand  over  the  other  laid  over  the  ear,  but  this  is  no 
longer  heard  when  effusion  of  liquid  has  taken  place  into  the 
pleurae.  Percussion  in  the  early  stages  detects  no  change  from 
the  healthy  chest  resonance. 

If  not  relieved  in  from  twenty- four  to  thirty-six  hours,  a  re- 
markable modification  of  the  symptoms  takes  place  indicating  the 
occurrence  of  effusion.  The  violent  symptoms  are  suddenly  re- 
lieved. The  quick  catching  breathing  which  is  in  many  cases  ac- 
companied by  a  grunt,  becomes  easy  and  though  fuller  than 
natural  is  comparatively  regular.  In  particular  the  inspiration  is 
free  and  full  and  comparatively  painless,  the  sudden  check  and 
the  grunt  by  which  it  was  arrested  having  alike  disappeared. 
The  tension  of  the  abdominal  muscles  and  the  tucked  up  appear- 
ance of  the  flanks  give  way  ;  the  pulse  acquires  a  softer  character, 
the  haggard  pinched  countenance  is  relaxed,  and  a  general  ap- 
pearance of  comfort  and  even  liveliness  prevades  the  animal.  This 
temporary  improvement  is  often  so  great  that  the  horse  will  take 
to  feeding  as  if  he  had  all  at  once  recovered. 

The  apparent  recover}^  is,  however,  only  transient.  Soon  the 
pulse  becomes  more  frequent  and  loses  its  fulness,  the  breathing 
is  more  laborious  and  attended  with  a  characteristic  lifting  of  the 
flanks  and  loins,  the  nostrils  are  widely  dilated,  the  limbs  out- 
stretched and  the  elbows  outturned,  the  eyes  stare  and  project 
and  the  countenance  has  a  haggard  appearance  indicating  threat- 
ened suffocation.  Partial  sweats  ma}^  break  out  on  the  surface, 
due  to  the  state  of  nervous  excitement  and  general  relaxation  and 
supplementing  in  some  degree  the  impaired  exhalation  from  the 
lungs.  Auscultation  over  the  lower  region  of  the  chest  shows  a 
complete  absence  of  the  respiratory  murmur,  rising  to  the  same 
level  precisely  at  all  points.  Percussion  elicits  no  resonance  on 
the  same  region.     If  the  effusion  has  taken  place  slowly  or  existed 


Acute  PleJirisy  in  the  Horse.     Pleuritis.  743 

for  soni2  tiin2,  thi  dulness  and  absence  of  sound  will  usually  in- 
dicate that  th2  liquid  ris2S  to  tha  same  level  on  both  sides.  So 
thin  and  permeable  is  the  posterior  mediastinum  in  its  lower  part 
that  unless  thickly  coated  by  new  solid  exudations,  the  effusion 
readily  passes  through  it  and  rises  to  the  same  height  on  both 
sides.  If  gas  as  well  as  liquid  is  produced  in  the  pleural  sac  a 
gurgling  or  splashing  sound  may  be  heard  on  auscultation,  and 
occasionally,  after  rising  or  other  change  of  position,  a  metallic 
tinkling,  due  to  droppings  from  the  shreds  of  false  membranes 
above  into  the  fluid  below. 

As  the  disease  proceeds  dropsical  effusions  are  observed  beneath 
the  skin  of  the  breast  and  abdomen,  a  mucous  rattle  is  heard  in 
the  trachea,  the  nose,  ears  and  limbs  become  cold,  the  pulse  in- 
creases in  rapidity  and  weakness,  shows  the  distinct  anaemic  tremor 
or  thrill,  and  becomes  rapidly  imperceptible  ;  the  horse  moves  un- 
steadily and  often  falls  suddenly  dead. 

This  early  fatality  is,  however,  only  seen  in  the  worst  cases. 
In  those  about  to  terminate  favorably  improvement  is  shown 
usually  about  the  fourth  day.  The  lifting  of  the  flanks  and  loins 
becomes  moderated,  the  ribs  move  more  freely,  the  grunt  ceases, 
the  pulse  is  fuller,  softer  and  less  frequent,  and  auscultation  and 
percussion  show  a  steady  decrease  in  the  effusion.  Appetite 
meanwhile  returns,  the  horse  moves  more  freely,  lies  down  for  a 
length  of  time  in  succession,  and  convalescence  lasts  from  two  to 
three  weeks. 

In  the  less  fortunate  cases  structural  changes  more  or  less  per- 
manent, keep  up  symptoms  of  illness  for  a  variable  length  of  time. 
Sometimes  after  the  liquid  effusion  has  been  absorbed  the  lung 
remains  attached  to  the  side  of  the  chest  by  newly  formed  tissue 
(false  membrane)  and  while  this  is  undergoing  a  drying  and 
organizing  process,  it  gives  rise  to  a  leathery,  creaking  sound 
heard  on  auscultation  and  easily  mistaken  for  crepitation.  Some- 
times an  abscess  forms  on  the  surface  of  the  pleura  or  in  the  newly 
organized  false  membrane,  and  either  bursts  into  the  pleural  sac 
(empyema)  where  it  serves  to  increase  and  sustain  the  irritation, 
or  it  makes  its  way  through  the  intercostal  spaces  and  is  discharged 
externally.  In  this  last  case  its  advance  toward  the  surface  is 
heralded  by  an  extensive  inflammatory  infiltration  and  pasty 
swelling  much  more  tender  to  the  touch  than  the  dropsical  swell- 


244  Veterinary  Medicine. 

ing  already  referred  to.  Another  condition  is  that  in  which  false 
membranes  of  considerable  thickness  invest  a  lung  and,  following 
the  law  of  all  fibrous  structures  in  process  of  organization,  they 
contract  and  cause  a  compression  and  partial  collapse  of  the  con- 
tained lung  tissue.  A  flattening  of  the  corresponding  side  of  the 
chest  and  a  muffled  and  almost  inaudible  respiratory  murmur  is 
the  result  of  this  condition.  In  some  measure  these  symptoms 
are  present  during  convalescence  in  all  cases  of  pleurisy  since  the 
lung  never  expands  to  its  full  size  till  some  time  after  apparent  re- 
covery, but  it  is  only  when  the  organ  is  invested  with  false  mem- 
brane that  the  symptoms  are  very  apparent. 

In  all  such  cases  of  prolonged  pleurisy  from  protracted  structural 
change  there  is  continued  illness  without  the  violent  symptoms  by 
which  the  acute  form  of  the  disease  is  manifested.  The  acute 
suffering,  the  restlessness,  the  grunt,  and  even  the  catching 
breathing  may  be  absent  ;  the  temperature  may  be  almost  reduced 
to  the  healthy  .standard,  the  pulse  small  and  tolerably  soft,  the 
appetite  considerably  improved  and  the  different  secretions  toler- 
ably normal ;  yet  the  pinching  of  the  intercostal  spaces  causes 
sharp  pain,  and  measurement,  auscultation  and  percussion  testify  to 
the  persistence  of  disease.  The  animal  is  hidebound,  unthrifty 
and  unequal  to  any  exertion.  The  cough  is  weak  and  painful  and 
sometimes  accompanied  by  a  grunt. 

Besides  the  changes  connected  with  exudation  and  effusion, 
and  organization  or  suppuration  in  the  exuded  products,  gangrene 
sometimes  results.     A  case  of  this  kind  is  related  by  Percivall. 

The  duration  of  pleurisy  may  thus  extend  from  two  days  in 
very  acute  cases  to  several  weeks,  or  even  months  if  we  estimate 
it  by  the  continuance  of  hydro-thorax  in  the  chronic  cases. 

Post  Mortem  Appearances.  These  consist  mainly  in  the  pres- 
ence of  false  membranes  lining  the  pleura  and  hanging  in  cobweb 
like  shreds  into  the  cavity  of  the  chest,  and  of  the  liquid  effusion 
which  fills  up  the  chest  at  its  most  dependent  part.  The  pericar- 
dium also  contains  fluid  in  many  cases.  The  periods  at  which 
exudation  takes  place,  and  when  the  principal  changes  take  place 
in  the  exuded  materials  have  been  well  investigated  by  Dupuy, 
Hamont,  Delafond  and  St.Cyr.  They  induced  pleurisy  by  inject- 
ing irritant  liquids  into  the  chest,  and  noted  the  regular  sequence 
of  changes. 


Acute  Pleurisy  in  the  Horse.     Pleuritis.  245 

Dupuy  injected  two  drachms  of  oxalic  acid  dissolved  in  three 
ounces  of  water.  Symptoms  of.  pleurisy  at  once  came  on,  with 
the  friction  sound  characteristic  of  its  early  stages.  Next  day 
friction  sound  had  ceased  and  evidence  of  effusion  existed.  The 
same  experiment  repeated  on  several  horses  showed  that  if  killed 
at  any  period  subsequently  to  this,  considerable  exudation  had 
already  taken  place.  In  one  horse  in  which  the  disease  was  of 
50  hours'  standing  the  chest  contained  43  pints  of  citrine-colored 
fluid,  and  abundance  of  yellow,  thick,  false  membrane  enveloping 
the  costal  and  pulmonary  pleurae. 

Hamont  injected  seven  ounces  of  a  weak  solution  of  tartaric 
acid  into  the  left  pleural  sac,  repeated  the  injection  next  morning 
and  destroyed  the  horse  twenty  minutes  afterward.  The  chest 
opened  immediately  showed  a  small  amount  of  liquid  on  the 
affected  side,  and  the  pleura  injected  and  reddened. 

Delafond  made  twenty-tw^o  experiments  with  the  same  general 
result. 

Percivall  found  recent  adhesions  between  the  lungs  and  side  so 
early  as  seventeen  hours  after  the  commencement  of  the  pleurisy. 

Andral  injected  rabbits  with  acetic  acid  and  in  nineteen  hours 
found  in  the  injected  pleura  soft,  thin,  false  membranes  traversed 
by  red  anastomosing  lines,  and  in  certain  cases  a  serous  or  puri- 
form  fluid. 

W.  Williams  found  a  false  membrane  formed  twenty-fours  after 
the  injection  of  the  irritant. 

St.  Cyr  in  a  series  of  43  experimental  and  casual  pleurisies  in 
horses,  found  that  in  a  very  few  hours  there  was  marked  local 
congestion  and  swelling  of  the  pleura  speedily  followed  by  the 
formation  of  soft,  pulpy,  friable  false  membranes,  largely  amor- 
phous and  granular  but  impregnated  with  many  cells  and  nuclei. 
These  adhere  feebly  to  the  pleura  but  may  accumulate  with  pro- 
digious rapidity  so  as  to  cover  in  three  or  four  days  the  whole 
pleural  surface  on  one  or  both  sides.  The  attendant  serous  effu- 
sion was  bloody,  turbid,  or  lactescent.  The  pleural  surface  under 
the  false  membrane  was  highly  vascular  and  studded  with  fragile, 
red  conical  elevations  projecting  into  the  membrane.  Exception- 
ally the  sub-serous  connective  tissue  became  the  seat  of  exudation 
as  well. 

From  the  sixth  to  the  ninth  day  the  false  membranes  began  to 


246  Veterinary  Medicine. 

become  vascular  and  from  the  tenth  to  the  fourteenth  day  com- 
menced to  organize  into  the  connective  tissue.  With  the  advent 
of  this  stage,  the  inflammatory  action  tended  to  subside,  and  the 
reabsorption  and  repair  to  ensue. 

Pleuritic  effnsio7i.  This  varies  greatly  at  the  different  stages  of 
the  disease.  As  effused  it  has  a  composition  resembling  that  of 
the  blood  :— 

Water, ---911   to     924 

Albumen,     -     -     -     -     -     -     -     -  -  63.33  to  82.50 

Fibrine  formers,     ------       2.16  to   12.50 

Extractive  matter. 
Salts. 
The  progressive  changes  from  the  haemorrhagic  effusion  to  the 
limpid  hydrothorax  and  their  relation  to  the  different  stages  of  the 
disease  and  the  subsidence  of  the  inflammation  are  of  the  greatest 
importance  in  deciding  questions  of  responsibility,  when  the 
animal  has  recently  changed  hands.  St.  Cyr  has  classified  his 
cases  in  the  following  instructive  table  : 


Effusions. 

Duration  of  the 
Disease. 

Port  Wine 

Sero-san- 
guineous. 

Muddy 

or 
Grayish. 

Limpid. 

Total. 

From   1st  to  7th  day. 

"      8th  to  15th  day. 

"    i6thto3othday. 
After  30th   day  .    .    . 

9 
2 

6 

3 

I 

3 
4 

6 

5 
3 

18 
15 

7 
3 

II 

10 

8 

14 

43 

Up  to  the  7th  day  50  per  cent  were  dark  red  ;  after  the  7th  da)^ 
only  13.3  per  cent  ;  and  after  the  15th  day  none.  Up  to  the  7th 
day  83.3  per  cent  were  either  dark  red  or  sero-sanguineous  and 
not  one  had  attained  to  translucency.  After  the  7th  day  only  8 
percent  were  of  port  wine  hue,  and  by  the  i5tli  day  24  per  cent, 
of  all  cases  of  over  seven  days  standing  were  already  transparent. 
Of  all  cases  of  over  15  days  standing,  80  per  cent,  were  perfectly 
translucent  and  none  showed  the  dark  red  hue.  Finally  after  the 
30th  day  all  remaining  cases  were  limpid.  This  of  course  must 
not  be  applied  with  the  same  confidence  in  both  directions.  While 
translucency  of  the  effusion   bespeaks  seven   days  standing  and 


Acute  Pleurisy  in  the  Horse.     Pleuritis.  247 

probably  fifteen  or  twenty,  the  dark  red  hue  must  not  be  held  to 
imply  a  recent  date  for  the  attack.  A  relapse  in  the  course  of  con- 
valescence may  easily  and  quickly  stain  anew  a  liquid  that  was 
already  limpid,  or  had  advanced  far  toward  this  condition. 

The  appearance  of  the  lung  tissue  in  a  case  of  confirmed  pleu- 
risy is  characteristic.  The  lung  is  of  a  dull  red  color,  shrunken, 
slightly  collapsed,  flabby,  scarcely  crepitant  under  pressure  and 
heavier  than  water  or  floating  in  water.  It  is  tough,  not  friable 
like  hepatized  lung,  and  its  cut  .surface  is  dry,  smooth,  and  pre- 
sents the  interlobular  septa  very  well  marked.  This  is  due  to  the 
compres.sion  by  effused  liquid,  and  by  the  organizing  and  contract- 
ing false  membranes  covering  the  lung  and  implies  nothing  more 
than  simple  condensation.  The  air  cell  may  be  collapsed,  but 
contains  no  new  product  and  has  not  parted  with  its  epithelium 
and  the  lung  can  be  inflated  through  the  bronchia. 

Differentiation  according  to  the  nature  of  the  effusion.  Pathol- 
ogists have  divided  acute  pleurisy  into  the  djy,  sero-fibrinotis,  and 
sero-fibro-purulent. 

1.  Dry  or  fibrinous  pleurisy  has  usually  a  more  acute  type 
and  the  exudate  containing  an  excess  of  the  fibrinogenous  elements 
forms  a  coagulum  or  false  membrane  on  the  affected  surface  tend- 
ing to  bind  that  to  the  part  adjacent — the  lungs  to  the  costal 
pleura.  The  serum,  small  in  quantity,  is  in  the  main  retained  in 
the  exudate  or  if  set  free  is  actively  reabsorbed  by  the  healthy 
pleura. 

2.  Sero-fibrinous  pleurisy.  This  form  is  u.sually  less  acute 
and  more  extended  involving  perhaps  an  entire  pleural  sac,  or 
even  both  sides  of  the  chest.  This  is  the  common  form  of  pleurisy 
and  is  that  referred  to  in  the  experiments  of  St.  Cyr  and  others 
above.  The  earliest  lesions  in  experimental  cases  (with  chloride 
of  zinc  solution)  in  dogs  are  an  uniform  bright  red  congestion, 
with  a  bright,  shining  .surface  as  yet  perfectly  dry.  There  is  al- 
ready shedding  of  patches  of  the  endothelial  cells,  swelling  and 
proliferation  of  the  superficial  connective  tissue  cells  and  the  for- 
mation of  a  few  pus  globules.  This  is  seen  in  from  half  an  hour 
to  six  hours  after  the  application  of  the  irritant. 

Next  follows  the  exudation  of  fibrine  and  serum,  which  respec- 
tively coagulate  as  false  membrane  on  the  inflamed  membrane,  or 
drop  to  the  bottom  of  the  sac  as  liquid.     The  fibrine  appears  as 


248  Vcteri)iary  Medicine. 

granules,  little  knobs  and  threads  between  and  on  the  endothelial 
cells  and  entangling  a  few  pus  cells.  The  changes  are  now  much 
more  marked  in  the  connective  tissue  cells,  which  are  more 
numerous,  larger,  nucleated  and  often  stellate  or  polygonal. 
Changes  are  well  advanced  in  twenty-four  hours.  The  cells 
go  on  increasing  to  the  fourth  or  fifth  da}^  when  new  blood  vessels 
are  formed  into  the  membrane  and  may  be  injected  from  the 
pleura.  From  this  time,  in  favorable  cases  absorption  of  the 
liquid  proceeds,  and  the  fibrine  is  organized,  and  by  the  fourteenth 
day  is  transformed  into  connective  tissue,  the  superficial  cells 
forming  endothelium  and  the  deeper,  branching  connective  tissue 
cells.  The  result  is  the  thickening  of  the  pleura  and  the  forma- 
tion of  adhesions.  The  case,  however,  may  prove  fatal,  or  it  may 
be  protracted  through  the  continued  production  of  fibrine  and 
serum,  or  it  may  pass  into  empyema. 

3.  Sero-fibrino-purulent  pleurisy.  Empyema.  This  is 
usuall}^  very  dangerous  as  well  as  complicated.  It  may  supervene 
on  the  last  described  form.  It  may  depend  on  rupture  into  the 
pleura  of  abscess  of  the  lung,  bronchial  glands,  liver,  diaphragm 
or  intercostal  space  and  the  infection  of  the  chest  cavity.  It  may 
in  the  same  way  follow  the  laceration  of  a  bronchium  by  a  broken 
rib,  the  perforation  of  the  intercostal  space  by  a  foreign  body,  or 
(in  cattle)  the  penetration  of  the  chest  by  a  sharp-pointed  body 
from  the  recticulum.  It  may  follow  at  once  on  pleurisy  of  a  very 
high  grade.  Probably  in  all  such  cases  there  is  infection  of  the 
pleura  by  pus  microbes.  When  there  is  a  communication  with  a 
bronchium,  the  reticulum  or  the  external  air  there  are  usually 
septic  germs  in  addition,  and  the  contents  of  the  chest  become 
foetid. 

The  purulent  fluid  may  accumulate  in  the  lower  part  of  the 
pleural  sac,  or  it  may  be  confined  in  abscess  form  in  the  false 
membrane,  and  extend  thence  into  surrounding  tissues.  The  pus- 
containing  pleura,  or  cavity  infected  by  the  pus  germs,  assumes 
the  appearance  of  a  granulating  surface,  or  of  the  lining  mem- 
brane of  an  abscess,  and  continues  to  produce  pus  in  greater  or 
less  amount. 

The  formation  of  pus  in  the  pleura  is  known  as  empyema. 
When  air  enters  the  pleura  through  a  wound  perforating  the  chest 
wall,  or  when  gas  is  formed  in  the  pleura,  the  condition  is  pneu- 


Acute  Pleurisy  in  the  Horse.     Pleuritis.  249 

mothorax.  As  liquid  is  usually  present  as  well  it  is  hydro-- 
pneumothorax. 

Tubercular  and  other  forms  of  pleurisy  have  in  certain  cases 
been  superadded  to  the  specific  local  lesions,  by  which  such  dis- 
eases  are  individually  characterized. 

Prognosis.  Occurring  in  an  otherwise  healthy  system  and 
especially  if  coutined  to  one  side  of  the  chest,  pleurisy  is  not  fre- 
quently fatal,  and  under  appropriate  treatment  recovery  is  often- 
times rapid  and  satisfactory.  A  certain  number  of  cases  merge 
into  chronic  hydrothorax,  the  inflammation  apparently  subsiding, 
but  reabsorption  failing  to  take  place.  The  hydrothorax  may 
last  for  months  or  even  a  year. 

Treatment,  if  seen  during  the  chill  and  before  inflammation 
has  been  definitely  established  every  effort  must  be  directed  to  se- 
cure its  abortion,  if  possible.  No  time  should  be  lost  in  placing 
the  patient  in  a  warm  comfortable  stall  or  box,  covering  him  with 
woolen  blankets  and  actively  rubbing  and  loosely  flannel  bandag- 
ing the  legs.  Warm  drinks  and  warm  injections  must  be  given. 
Half  an  ounce  or  an  ounce  of  camomile  or  boneset  in  infusion 
in  two  or  three  quarts  of  hot  water,  or  in  the  absence  of  this 
any  of  the  carminatives,  or  etherial,  alcoholic  or  ammoniacal 
stimulants  may  be  given.  Pilocarpin  in  7  grain  dose  hypodermi- 
cally  may  promptly  secure  a  revulsion  of  blood  to  the  skin  and  at 
once  overcome  the  chill  and  prove  a  most  effective  derivative  from 
the  pleura.  Placing  the  legs  in  buckets  of  hot  water,  or  the  whole 
animal  in  a  hot  air  bath  will  often  act  equally  well.  Packing  the 
chest  and  even  the  abdomen  in  a  blanket  wrung  out  of  very  hot 
water  and  covering  it  closely  by  one  or  two  dry  ones,  or,  better 
still,  by  a  rubber  or  other  impermeable  covering,  will  long  retain 
both  heat  and  moisture,  securing  free  cutaneous  circulation,  and 
soothing  in  a  most  effective  way  the  irritation  in  the  chest.  This 
may  be  maintained  as  long  as  requisite  to  relieve  the  patient,  and 
then  the  body  may  be  uncovered,  apart  at  a  time,  rubbed  dry  and 
covered  with  a  dry  woolen  blanket.  By  using  elastic  circingles 
over  the  compress  they  are  adapted  to  the  respiratory  movements 
and  any  restriction  in  the  movement  of  the  ribs  is  beneficial  by 
limitnigthe  friction,  pain  and  irritation  in  the  pleura. 

In  the  second  stage,  when  inflammation  has  already  set  in,  the 
same  general  measures  of  derivation  toward  the  skin  and  hot  bath 


250  Veterinary  Medicine. 

or  soothing  derivative  compress  are  still  demanded  though  they 
may  be  substituted  by  more  stimulating  derivatives.  The  bleed- 
ing of  the  patient  into  his  own  vessels  is  sought  in  various  ways. 
On  the  continent  of  Europe  stimulating  embrocations  (essential 
oils,  ammonia  and  oil,  nuistard,  etc.)  are  applied  to  the  limbs. 
In  America  and  England  similar  agents  are  more  commonly  ap- 
plied to  the  walls  of  the  chest  and  dry  cupping  in  the  .same  region 
has  been  resorted  to.  Metallic  cups  with  small  mouths  and  having 
a  capacity  of  about  a  pint  each,  have  the  air  rarefied  by  plunging 
into  each  a  spirit  lamp,  and,  on  its  withdrawal,  suddenly  applying 
the  mouth  of  the  cup  on  the  .skin  of  the  co.stal  region  previously 
well  coated  with  lard.  Another  form  of  cup  is  made  with  a  tube 
and  stopcock  in  its  otherwise  blind  end  by  means  of  which  it  is 
exhausted  with  a  syringe  after  its  mouth  has  been  applied  to  the 
skin.  In  the  absence  of  both  a  narrow  mouthed  glass  tumbler 
may  be  employed,  the  air  is  rarified  by  inserting  into  it  a  burning 
spill  of  paper  or  wood  for  a  few  seconds  and  on  its  withdrawal  the 
cup  is  instantly  inverted  on  the  skin.  If  the  animal  is  very  hairy 
or  very  thin  it  may  be  necessary  to  shave  the  .part,  and  smear 
with  oil  and  even  to  select  a  very  narrow  mouthed  cup.  When 
applied  the  cup  is  cooled  with  water  or  otherwise  and  owing  to 
the  partial  vacuum  the  skin  is  .strongly  drawn  up  into  it  and.  the 
blood  accumulates  in  and  under  the  skin.  It  may  be  kept  on  for 
half  an  hour  at  a  time  and  witli  ten  or  twelve  cups  on  one  side 
the  patient  tends  to  profu.se  perspiration  establishing  a  strong  re- 
vulsion toward  the  skin,  and  great  relief.  In  dangerous  cases 
three  or  four  applications  may  be  required  in  twenty-four  hours. 

Next  to  this  the  mustard  application  is  perhaps  the  safest  and 
most  valuable.  The  be,st  ground  mustard  (black  by  preference) 
is  made  into  a  very  thin  pulp  with  tepid  or  cold  (never  hot  nor  boil- 
ing) water  and  rubbed  in  against  the  hair  so  as  to  soak  the  surface 
of  the  skin  ;  it  is  then  closely  covered  with  paper  and  with  a  rub- 
ber or  other  impervious  covering  or,  in  default  of  better,  with  a 
close  blanket  and  left  on  for  two  hours.  By  this  time  the  skin 
should  be  thickened  to  the  extent  of  at  least  a  quarter  of  an  inch 
and  the  derivation  and  relief  will  be  very  manifest. 

Cantharides  is  sometimes  used  but  like  most  other  severe  irri- 
tants, is  liable  to  induce  sympathetic  irritation  in  an  already  se- 
verely inflamed  pleura,  and  thus  to  obviate  all  benefit.  Canthar- 
ides is  also  liable  through  extensive  absorption  to  irritate  the  kid- 


Acute  Pleurisy  iu  the  Horse.     Pleuritis.  251 

neys.  To  counteract  this  Bouley  gave  ^4  drachm  doses  of  cam- 
phor with  alleged  good  effect. 

Some  practitioners  make  local  applications  of  hot  water  and  of 
aqua  ammonia  (confined)  but  unless  very  closely  watched  these 
are  liable  to  destroy  the  hair  follicles  and  produce  permanent 
blemish. 

The  hot  air,  steam  bath,  and  hot  compress  have  the  advantage 
over  the  mere  irritant  derivatives  that  their  action  is  from  first  to 
last  soothing  and  free  from  all  risk  of  inducing  sympathetic  irrita- 
tion and  yet  as  derivatives  they  are  eminently  efficient.  Next  to 
them  in  safety  and  efficacy  comes  dry  cupping. 

The  irritant  derivatives  are  often  the  most  valuable,  but  must 
be  used  with  great  judgment.  They  are  always  dangerous  when 
the  pleural  inflammation  runs  very  high  and  when  the  local  irri- 
tation and  suffering  are  specially  acute.  Under  such  circum- 
stances it  is  usually  desirable  to  adopt  other  measures  to  moderate 
the  severity  of  the  inflammation,  and  to  fall  back  on  baths,  com- 
presses and  cups  until  the  irritation  is  alleviated  before  vegetable 
or  animal  vesicants  are  resorted  to.  In  acute  and  severe  attacks 
these  latter  are  especially  applicable  to  the  early  stages  before  the 
inflammation  has  been  fully  formed,  or  after  the  .stage  of  free 
effusion  has  set  in. 

With  high  fever  and  no  benefit  from  hot  local  applications, 
cold  irrigation  or  refrigerant  compresses  to  the  walls  of  the  chest, 
have  proved  useful,  but  considering  the  role  filled  by  cold  in  cau- 
sation and  the  suggested  relation  between  pleurisy  and  rheuma- 
tism this  is  not  to  be  followed  as  a  general  practice. 

If  the  patient  has  been  a  hearty  feeder  and  if  there  is  evident 
costiveness  a  purgative  (aloes  or  sulphate  of  soda)  is  often  desira- 
ble at  the  outset,  but  if  the  disease  is  of  a  low  type  this  is  always 
dangerous,  owing  to  susceptibility  of  the  intestinal  mucosa  and  it 
is  safer  to  correct  constipation  by  injections  or  at  most  by  a  pint 
of  olive  oil. 

When  the  suffering  is  very  acute  and  is  aggravating  the  fever, 
a  hypodermic  injection  of  morphine  will  often  greatl}^  relieve  and 
even  favor  a  revulsion  of  blood  toward  the  .skin,  but  as  it  tends  to 
suppress  the  action  of  both  bowels  and  kidneys  it  should  be 
avoided  unless  it  seems  absolutely  necessary,  and  above  all  it 
slionld  not  be  given  by  the  stomach.  Cocaine  hypodermically 
may  be  used  to  relieve  pain. 


252  Veterinary  Medicine. 

Both  fever  and  suffering  can  sometimes  be  greatly  relieved  by 
large  doses  (2  drachms  3  or  4  times  daily)  of  salicylate  of  soda, 
which  again  suggests  a  close  relation  of  the  disease  to  rheumatism. 
Acetanilid  or  phenacetin  may  be  used  to  fill  the  same  indication. 

Next  come  the  questions  of  alkaline  and  diuretic  treatment. 
Some  cases  do  well  if  given  nitrate  of  potash  freely  in  the  drink- 
ing water.  Some  prefer  the  alkaline  diuretics,  such  as  acetate  of 
potash  or  ammonia,  bicarbonate  of  potash  or  soda,  biborate  of 
soda,  or  the  vegetable  diuretics  such  as  colchicum,  squills,  etc. 
Fraenkel  found  that,  while  comparatively  ineffective  alone,  these 
proved  most  efficient  (in  man)  when  combined  with  cinchona  or 
other  bitter.  The  hint  should  be  useful  to  the  veterinarian.  Di- 
uretics in  the  stage  of  effusion  should  be  pushed  as  far  as  the 
strength  of  the  patient  will  warrant. 

Friedberger  and  Frohner  recommend  pilocarpin,  and  no  agent 
produces  an  equal  secretion  from  the  natural  emunctories  and  an 
equal  tendency  to  reabsorption.  It  is  however  so  profoundly 
exhausting  that  it  must  be  used  with  the  greatest  judgment 
and  caution. 

Digitalis  has  often  an  excellent  effect.  Though  not  primarily 
a  diuretic,  it  is  a  powerful  tonic  of  the  heart  and  circulation,  and 
by  increasing  the  blood  tension  it  usually  produces  a  free  flow 
of  urine.  In  combination  with  the  diuretic  salts  it  may  be  used 
from  the  first  but  it  is  especially  valuable,  after  effusion  and  when 
attention  must  be  given  mainly  to  securing  reabsorption.  Care 
is  demanded  that  we  avoid  its  cumulative  action,  and  in  place  of 
continous  large  doses,  a  strong  infusion  applied  over  the  loins  will 
sometimes  have  a  good  effect.  It  may  also  be  combined  with 
bitters  and  even  with  ferruginous  tonics  in  the  advanced  stages. 

In  combination  with  neutral  salts  and  digitalis,  iodide  of  potas- 
sium would  seem  to  be  indicated.  Results  however  do  not  show 
a  great  superiority  to  other  diuretics  in  favoring  absorption. 

Tincture  of  iodine,  painted  upon  the  chest  over  the  affected 
parts,  and  repeated  until  tender,  acts  more  or  less  as  both  a  de- 
rivative and  deobstruent.  A  liniment  of  iodide  of  potassium  and 
soap  is  a  convenient  form  of  application. 

The  inunction  of  the  chest  walls  with  mercurial  ointment  has 
strong  advocates  both  among  physicians  and  veterinarians,  and 
is   combined  in  such  cases  with  the    exhibition    of   calomel   in- 


Pleurisy  in   Cattle.  253 

ternally.     Unless  the  good  effects  are  shown  in  a  day  or  two  it 
may  well  be  abandoned. 

When  effusion  becomes  dangerous  through  excess,  and  in  ad- 
vanced cases  when  it  fails  to  yield  to  medicinal  measures  thora- 
centesis is  called  for.      (See  under  hydrothorax.) 


PLEURISY  IN  CATTLE, 

Milch  cows  and  work  oxen  most  liable.  Causes.  Damp  buildings  and 
locations,  sudden  transitions  from  heat  to  cold,  exposure  when  fatigued,  etc. 
Symptoms,  rigor,  reaction,  cold  horns  and  limbs,  later  hot,  excited  pulse, 
catchingbreathing,  hyperthermia,  104°  to  105°,  tender  chine  and  intercostals, 
friction  sound,  later  dulness,  creaking,  weaker  murmur,  subacute  cases 
often  tuberculous,  effusion  unilateral,  chronic  cases.  Lesions,  as  in  horse 
with  superficial  marbling  of  lung.  Treatment,  laxative,  warm  drink, 
compresses,  derivatives,  sedatives,  diuretics,  heart  tonics,  diuretics, 
thoracentesis. 

This  is  not  common  in  young  growing  cattle,  but  is  more 
frequent  in  milch  cows  and  work  oxen.  It  is  due  to  the  same 
causes  as  in  the  horse,  and  especially  to  chills  when  heated, 
damp  buildings  and  locations,  cold  draughts  between  open  windows 
or  doors,  and  cold  storms.  The  greatest  danger  comes  from 
hot,  close  stables,  like  many  distiller}^  stables,  approximating  to 
the  temperature  of  the  animal  body  and  from  which  the  stock  are 
suddenly  turned  out  of  doors,  or  shipped  by  car  or  boat  with  a 
temperature  near  zero,  and  above  all  if  furnished  ice  water  to 
drink.  Such  animals  taking  no  exercise  to  increase  the  circu- 
lation and  heat,  are  especially  liable  to  shiver  and  contract  illness. 
Rigors  too  are  easily  induced  in  animals  .standing  in  hot  buildings, 
when,  in  connection  with  the  cleaning,  an  adjacent  door  is  thrown 
wide  open  or  two  on  opposite  sides  of  the  house.  Working  oxen 
heated  with  exerci.se  and  then  exposed  to  extreme  cold  and  com- 
pulsory inaction  are  endangered. 

Symptoms.  The  attack  is  manifested  by  the  same  general 
symptoms  as  in  the  horse.  The  rigors  are  often  very  well  marked, 
especially  over  the  shoulder  ;  the  tenderness  of  the  chine  and 
intercostal  spaces  is  striking  ;  the  breathing  is  catching  but  there 


54  Veterinary  Medicine. 

is  rarely  the  same  restlessness  as  in  the  horse ;  the  bowels  are 
costive,  appetite  and  rumination  impaired  or  suspended,  and  the 
paunch  is  often  distended  with  gas.  The  tenderness  of  the 
intercostal  spaces,  the  friction  sound  of  the  pleura,  and  the  main- 
tenance of  the  respiratory  murmur  and  the  normal  resonance  of 
the  lung,  become  the  ultimate  diagnostic  symptoms.  The  pulse 
may  be  70°  and  upward,  the  temperature  above  104°  to  105°. 
In  some  insidious  cases  indeed  the  fever  is  very  slight  and  besides 
the  general  wasting  of  the  animal,  the  indications  obtained  by 
physical  examination  alone  enabled  us  to  recognize  the  malady. 
Tuberculous  pleurisy  which  is  very  common  in  cattle  is  to  be 
suspected  in  such  cases. 

Effusion  is  recognized  by  the  dulness  of  the  lower  part  of  the 
chest  up  to  a  certain  line,  and  often  unilateral,  by  the  softer 
pulse,  by  the  dilated  nostrils,  or  open  mouth,  the  contracted 
facial  muscles,  by  the  glazed  eye,  and  anxious  expression,  by 
oppressed  breathing  and  often  by  engorgement  under  the  chest 
and  in  the  limbs. 

When  the  disease  lasts  over  ten  or  twelve  days  it  tends  to  pass 
into  the  chronic  form.  Or  a  chronic  pleurisy  of  a  subacute  type 
may  begin  dc  novo  and  pursue  an  insidious  and  latent  course. 

If  the  disease  commences  as  a  subacute  affection  there  may 
have  been  for  a  month,  capricious  appetite,  general  illhealth 
and  falling  away  b2fore  any  other  symptom  is  noticed.  Now 
the  breathing  is  manifestly  excited,  a  small,  short  cough  is  heard 
at  intervals,  the  pulse  is  accelerated  but  weak,  and  pinching 
auscultation  and  percussion  detect  unequivocal  signs  of  pleurisy. 
From  this  the  symptoms  become  more  decided  though  for  a  length 
of  time  they  are  very  slight,  the  animal  meanwhile  becomes 
increasingly  emaciated,  and  perishes  ultimately  in  a  state  of  great 
weakness.  Such  insidious  cases  are  always  to  be  suspected  of 
tuberculosis. 

The  post  morte77i  appcaraiices  resemble  those  of  the  horse. 
The  surface  of  the  lung  beneath  the  diseased  portions  of  pleura, 
however,  often  presents  a  marbled  appearance  from  the  infiltration 
of  the  areolar  tissue  between  the  adjacent  pulmonary  lobules. 
The  organization  of  the  false  membranes  begins  on  an  average 
about  the  tenth  day. 

Treatment.     The  same  general  principles  must  be  followed  as 


Pleurisy  in   Cattle.  255 

in  the  horse.  Bleeding  can  rarely  be  employed,  partly  because 
the  disease  so  often  assumes  a  subacute  form,  and  partly  because 
when  first  seen  considerable  effusion' has  often  already  taken  place 
and  severe  depletive  measures  are  thereby  contraindicated. 

A  laxative  dose  (i  Hb.)  of  sulphate  magnesia,  may  be  given  in 
warm  gruel,  and  the  same  means  by  compresses,  hot  fomentations 
and  counterirritation  adopted,  and  the  same  sedative  and  diuretic 
medicines  given  as  in  the  horse.  In  the  advanced  stages  and  in 
the  low  types  of  the  di.sease  the  stimulating  diuretics  (sweet  spirits 
of  nitre,  and  liquor  of  the  acetate  of  ammonia)  and  vegetable  and 
mineral  tonics  are  especially  indicated.  The  diet  in  these  last 
types  must  be  nutritive,  laxative  and  easily  digested. 

Tapping  of  the  chest  is  equally  applicable  as  in  the  horse,  (ySee 
Hydrothorax. ) 

In  the  chronic  forms  everything  is  to  be  done  to  support  the 
general  health  whether  by  food  stimulants  or  tonics,  and  counter- 
irritants  may  be  applied  several  times. 


PLEURISY  IN  SHEEP. 

Causes,  exposure,  after  clipping,  washing  in  cold  weather,  alternations 
from  hot  buildings  to  cold  fields,  shedding  of  the  wool.  Symptoms,  hyper- 
thermia, troubled  breathing  and  pulse  with  catching  inspiration,  tender  in- 
tercostals,  friction  sound,  and  signs  of  effusion.  Treatment,  preventive, 
shelter,  febrifuges  in  food  or  water,  aqua  ammonia  to  sides. 

The  causes  of  pleurisy  in  sheep  may  be  largely  included  in  the 
general  statement — expostire.  Cold  washing  and  exposure  after 
clipping  is  especially  injurious.  Devieusart  saw  300  cases  of 
pleuri.sy  and  thirty  deaths  in  a  flock  of  sheep  shorn  in  February. 
If  kept  secluded  in  warm  buildings  sheep  may  be  shorn  in  mid- 
winter, but  any  reckless  exposure,  and  any  sudden  reduction  of 
the  temperature  of  the  building  is  liable  to  be  disastrous.  Scab 
and  other  skin  affections  which  lead  to  a  shedding  of  the  wool  in 
inclement  weather  may  also  be  the  occasion  of  widespread  attacks. 
Otherwise  the  causes  are  es.sentially  those  of  the  same  disease  in 
the  larger  animals. 

The  symptoms  re.semble  those  of  pneumonia,  but  with  the  pe- 
culiar sharp,  short  arrest  of  the  inspiration,  and  the  marked  ten- 
derness of  the  intercostal  spaces  as  above  described.  The  cough 
is  short,  dry,  hacking  and  infrequent  or  suppressed  as  much  as 
pos.sible.  Auscultation  and  percussion  signs,  corresponding  to 
those  found  in  other  animals,  are  easil}^  got  in  the  newly  shorn 
.sheep.  In  the  unshorn  the  wool  must  be  parted  and  a  stethescope 
employed. 

The  treatment  is  mainly  preventive,  or  when  the  disease  is 
present,  of  a  general  nature  applicable  to  flocks.  A  warm  barn, 
with  pure  air,  blanketing,  wet  compresses,  to  which  may  be  added 
extract  of  henbane,  and  nitrate  of  potash  in  the  drinking  water 
give  examples  of  general  medication.  As  a  derivative,  aqua  am- 
monia and  oil  may  be  applied  in  lines  on  the  chest  exposed  by 
parting  the  wool  or  generally  on  the  .shorn.  Where  the  patient 
can  receive  the  requi.site  attention  further  treatment  .should  be  on 
lines  laid  down  for  cattle. 


256 


DOG.     PLEURISY. 

Causes,  exposure  to  cold,  etc.  Chill,  reaction,  disturbed  breathing, 
catching  inspiration,  rapid,  hard  pulse,  hyperthermia,  tender  chest,  friction 
sound,  later  dullness  at  lower  part  of  the  chest  in  any  position.  Treatment, 
as  in  pneumonia,  with  antirheumatics  and  diuretics  freely.      Thoracentesis. 

This  is  occasionally  seen  in  the  dog  as  the  result  of  exposure, 
and  like  other  diseases  of  the  chest  is  easily  recognized.  It  owns 
the  same  causes  with  pneumonia. 

Symptoms.  There  is  first  dulness,  shivering  and  some  excite- 
ment of  respiration.  To  this  follow  the  more  acute  symptoms, 
the  hard  pulse,  the  rapid,  catching  breathing,  the  animal  standing 
or  sitting  on  his  haunches,  the  open  mouth,  pendent  tongue,  the 
injected  mucous  membrane,  the  costiveness,  but  above  all  the 
tenderness  of  the  intercostal  spaces,  the  early  friction  sound  on 
auscultation,  the  pain  and  normal  resonance  on  percussion,  the 
muscular  twitchings  and  the  short,  suppressed,  painful  cough. 
When  effusion  has  occurred  its  amount  may  easily  be  estimated 
by  turning  the  animal  alternately  on  its  feet,  back  and  haunches, 
and  observing  how  high  the  dullness  extends  in  these  various 
positions. 

The  same  treatment  may  be  adopted  as  in  pneumonia,  with  this 
difference  that  salicin  may  be  given  freely,  and  when  effusion  has 
taken  place  active  diuretics  are  specially  indicated,  and  hence 
tincture  of  squils  (a  teaspoonful)  may  be  made  to  replace  the 
nitre.  In  advanced  and  obstinate  cases,  or  where  danger  exists 
from  rapid  effusion,  the  liquid  may  be  drawn  off  with  a  cannula 
and  trochar  as  in  other  animals. 


17  257 


PLKURO-PNEUMONIA.     BRONCHO-PNEUMONIA. 
BRONCHO-PIvEURO-PNEUMONIA. 

Though  we  often  meet  with  typical  forms  of  bronchitis,  pneumo- 
nia ^ndi  pleicrisy ,  it  is  much  more  common  to  find  them  combined 
more  or  less  with  each  other.  Thus  combined  inflammation  of 
the  bronchial  tubes  and  pulmonary  substance  is  frequent ;  inflam- 
mation affecting  both  the  lung  and  its  investing  pleural  membrane 
is  no  less  common  ;  and  cases  are  seen  in  which  all  three  struc- 
tures are  involved.  These  conditions  are  to  be  recognized  by  the 
presence  of  the  symptoms  of  both  the  coexisting  maladies  but 
particularly  by  the  indications  furnished  by  touch,  auscultation 
and  percussion.  The  predominance  of  one  disease  over  another 
will  decide  the  nature  of  the  treatment  which  must  be  adapted  to 
the  peculiar  character  of  each  case  whether  tnainly  bronchitic, 
pneicmonic,  or  pletiritic.  It  is  these  mixed  cases  that  test  the 
ability  and  judgment  of  the  practitioner  as  he  must  carefully  in- 
dividualize each  case,  ascertain  the  different  parts  affected,  the 
grade  of  the  inflammatory  action,  the  nature  of  the  attendant 
fever,  the  presence  or  absence  of  epizootic  influence,  etc.,  and  hav- 
ing all  these  conditions  in  view  must  apply  remedial  measures  ac- 
cordingly. 

It  must  be  evident  that  particular  directions  cannot  be  supplied 
for  all  of  these  cases.  General  principles  only  can  be  inculcated 
and  their  adaptation  to  the  varied  phases  of  different  cases  left  to 
the  judgment  of  the  student. 


258 


HYDROTHORAX. 

All  animals  liable.  Causes,  pleurisy,  obstruction  to  pulmonary  or  inter- 
costal veins,  heart  disease,  Brigbt's  disease,  anaemia,  parasitic  or  otherwise. 
Effusion  reddish  gray  or  clear  straw  color,  inflammatory  and  dropsical. 
Symptoms,  troubles  of  respiration,  as  a  secondary  disease  complicated  by 
dropsies  elsewhere,  signs  of  hydrothorax  without  fever,  shedding  of  hair. 
Treatment,  diuretic,  tonic,  derivative,  thoracentesis,  trochar  and  cannula  or 
aspiration,  point  of  election  for  puncture,  method,  asepsis,  drainage  by  as- 
pirator, or  into  an  aatisspti-c  solution,  eligible  cases,  dangers  attending 
thoracentesis,  shock,  rupture  of  false  membranes  and  lung,  infection  of 
pleura,  injection  of  antiseptics. 

HydrotJiorax  or  water  in  the  chest  is  common  to  all  domestic 
animals.  It  is  as  we  have  seen  one  of  the  most  ordinary  results 
of  pleurisy,  and  may  persist  long  after  that  disease  has  disappeared. 
It  likewise  occurs  independently  of  inflammation  as  a  dropsical 
effusion.  Thus  when  the  return  of  blood  by  the  bronchial,  pul- 
monary or  intercostal  viens,  is  hindered  by  any  cause  such  as 
tumors  in  the  bronchial  glands  or  subvertebral  region  a  passive 
effusion  may  take  place  through  the  coats  of  the  vessels.  In  im- 
perfection of  the  mitral  valves  the  regurgitation  of  blood  in 
the  pulmonary  veins  during  each  cardiac  systole  equally  causes 
such  transudation.  Chronic  disease  of  the  kidneys  (Bright's  dis- 
ease) with  the  retention  of  effete  and  injurious  materials  in  the 
blood  leads  to  drops}^  of  the  chest  as  in  other  parts  of  the  body. 
Again  in  many  debilitated  conditions  parasitic  and  otherwise,  with 
a  tendency  to  general  dropsy  the  chest  participates  and  a  collec- 
tion of  fluid  takes  place  in  the  pleurae. 

The  nature  of  the  contained  fluid  will  varj^  according  to  the 
conditions  in  which  it  has  been  effused.  If  the  result  of  inflam- 
mation there  are  the  different  stages  already  indicated  :  first,  of  a 
yellow  citrine  color  or  red  from  contained  blood  ;  second,  grayish 
and  muddy  either  from  contained  pus  or  other  changes  taking 
place  in  the  fluid  ;  and  third,  clear  limpid  and  translucent  as  seen 
in  the  later  stages.  If  merely  a  dropsical  effusion  the  fluid  is 
watery  clear  and  transluent  or  with  a  slight  straw  color.  The  in- 
flammatory effusion  contains  fibrine  or  fibrinogenous  elements,  is 
associated  with  the  formation  of  false  membranes,  and  though  it 

259 


26o  Veterhiary  Medicine. 

may  remain  fluid  so  long  as  it  is  retained  in  the  chest,  it  coagu- 
lates rapidly  when  withdrawn.  The  dropsical  effusion  rarely 
contains  fibrine,  and  then  only  in  very  small  amount,  and  it  does 
not  coagulate  when  drawn  off  from  the  chest.  The  inflammatory 
effusion  usually  contains  a  greater  proportion  of  common  salt, 
phosphates  or  albumen  than  exist  in  the  blood,  and  floating 
granules,  particles  and  cell  forms,  none  of  which  conditions  charac- 
terize the  dropsical  effusions.  The  most  prominent  feature  of 
the  inflammatory  effusions  is  thus  seen  to  be  their  power  of  co- 
agulation, by  virtue  of  the  contained  fibrine,  when  exposed  to 
the  air. 

Symptoms.  When  a  sequel  of  pleurisy  it  is  manifested  b}^  the 
symptoms  already  mentioned  under  that  head  as  indicating  the  oc- 
currence of  effusion. 

The  dropsical  cases  may  come  on  rapidly  and  present  all  the 
signs  of  troubled  respiration  together  with  the  results  of  ausculta- 
tion and  percussion  that  characterize  rapid  inflammatory  effusion 
but  without  the  fever  and  acute  symptoms  of  pleurisy.  More 
usually  it  comes  on  insidiously,  the  lung  accommodates  itself  to 
the  gradual  increase  of  the  fluid  and  it  is  only  when  the  accumu- 
lation has  become  excessive  that  the  symptoms  become  promi- 
inent.  In  heart  or  kidney  disease  the  filling  of  the  legs  and  infil- 
trations of  the  eyelids  and  of  the  skin  beneath  the  chest  and  ab- 
domen are  precursors  or  early  concomitants  of  the  disease,  but  in 
all  cases  the  accumulation  in  the  chest  is  to  be  measured  by  the 
height  of  the  line  of  dulness  on  percussion  and  the  extent  of  chest 
surface  giving  forth  no  respiratory  murmur  on  auscultation.  As 
the  liquid  rises  on  both  sides  of  the  chest,  as  it  always  does  in  such 
cases  in  the  horse,  the  breathing  becomes  short  and  labored,  being 
chiefly  effected  by  the  action  of  the  diaphram  and  the  flanks — the 
ribs  moving  only  slightly.  The  nostrils  are  widely  dilated  with 
each  breath.  The  previously  existing  want  of  vigor  and  energy, 
the  weak  pulse,  the  poor  appetite  and  the  pallor  of  the  mucous 
membranes  become  aggravated  ;  the  animal  becomes  very  weak 
and  prostrate,  the  loins  insensible,  the  permanently  tucked  up 
flanks  labor  tumultuously,  the  loins  rise  in  inspiration,  the  face 
is  pinched  and  haggard,  the  eyeballs  glazed  and  protruding,  and 
death  is  preceded  by  the  same  general  symptoms  as  in  rapid  effu- 
sion after  pleurisy.     A  prominent  feature  of  this,  as  of  all  dropsi- 


HydrotJwrax.  261 

cal  affections,  and  one  usually  seen  in  the  hydrothorax  of  inflam- 
mation as  well,  is  the  ease  with  which,  even  at  an  early  stage  of 
the  disease,  the  long  hairs  of  the  mane  and  tail  may  be  pulled  out. 
In  many  cases  they  come  out  in  handfulls  when  the  comb  or  the 
fingers  are  passed  through  them. 

Treatment.  The  treatment  must  be  of  the  actively  diuretic 
kind  recommended  for  the  effusion  of  pleurisy.  It  is  modified 
however  in  one  respect.  The  inflammatory  action  having  subsided 
or  nearly  so  and  the  condition  being  now  essentially  one  of  weak- 
ness a  free  use  of  tonics  is  demanded.  Many  a  patient  dies  in  such 
circumstances  from  the  actively  depletive  treatment  to  which  it 
has  been  subjected  and  the  want  of  attention  to  its  need  of 
generous  diet  and  other  support.  The  agents  prescribed  for  the 
advanced  stage  of  pleurisy  may  be  given,  or  the  digitalis  or  other 
diuretics  and  bitters  may  be  combined  with  iodide  of  potassium 
in  one  or  two  drachm  doses,  the  amount  being  apportioned  to  the 
strength  of  the  animal.  Iron  in  the  form  of  sulphate,  perchloride 
or  iodide  may  be  freely  given  combined  with  gentian,  quassia,  or 
other  vegetable  tonic,  and  above  all  a  liberal  and  easily  digested 
diet  must  be  allowed.  Good  will  sometimes  result  from  repeated 
applications  of  strong  iodine  ointment  to  the  sides  with  active 
friction. 

When  the  condition  is  dependent  on  disease  of  the  heart,  kid- 
ney or  other  organ,  these  must  be  attended  to  according  to  their 
special  requirements. 

Disconnected  from  such  complications  hydrothorax  will  often 
give  way  to  an  active  treatment  similar  to  that  indicated  above. 
In  .some  cases  however  our  only  hope  of  even  temporarily  pro- 
longing life  lies  in  the  operation  for  drawing  off  the  fluid. 

Tapping  the  chest  or  as  it  is  technically  called  thoracentesis 
or  paracentesis  thoracis  has  proved  sufficiently  successful  in  the 
lower  animals  to  warrant  its  continuance  in  cases  that  resist  other 
modes  of  treatment.  It  is  highly  probable  that  the  larger  pro- 
portion of  unsuccessful  cases  is  due  in  great  part  to  the  hopelessly^ 
advanced  stage  at  which  it  is  often  had  resort  to,  to  the- 
insufficient  precautions  adopted  in  its  performance,  and.  to  the 
want  of  appropriate  dietetic  and  medicinal  treatment.  Dr.  Bow- 
ditch's  treatment  hy  paracentesia  saved  in  the  human  subject  at  the 
rate  of  about  two  patients  in  five  and  we  ought  by  availing  of 
similar  precautions  to  reach  the  same  .standard. 


262  Veterinary  Medicine. 

The  cannula  employed  in  veterinary  practice  is  a  silver  tube  two 
inches  in  length,  a  quarter  of  an  inch  in  diameter  and  furnished 
with  a  shield  of  the  same  metal  at  one  end.  The  trochar  by  which 
it  is  introduced  is  of  steel  or  brass.  To  carry  out  Dr.  Bowditch's 
system  the  operator  must  supply  himself  with  a  syringe  of  a  some- 
what smaller  bore  and  an  intermediate  brass  piece  of  a  size  adapted 
to  fit  accurately  into  the  cannula  and  supplied  with  a  stopcock.  By 
an  instrument  of  this  kind  the  fluid  can  be  drawn  off  by  means  of 
the  syringe  without  any  risk  of  the  introduction  of  aerial  germs 
which  always  tend  to  induce  suppuration  and  even  a  putrefactive 
decomposition  in  the  contained  fluid. 

The  point  selected  to  operate  on  is,  in  the  horse,  ox  or  dog,  in 
front  of  the  anterior  border  of  the  ninth  rib,  at  its  lower  end  or 
close  to  its  union  with  the  cartilage.  The  point  of  the  trochar 
should  be  directed  slightly  upward  and  forward  to  avoid  the  pos- 
sibility of  injuring  the  diaphragm.  The  skin  is  first  rendered 
aseptic  by  shaving,  followed  by  a  thorough  soapy  wash  and  a  free 
use  of  mercuric  chloride  solution  (1:500).  It  is  then  pricked 
with  a  lancet,  then  drawn  aside  that  the  wounds  in  the  skin  and 
muscles  may  not  correspond  after  the  cannula  has  been  withdrawn. 
The  trochar  is  then  pushed  steadily  through  the  intercostal  space 
till  all  obstruction  has  been  overcome,  when  it  may  be  concluded 
that  the  pleural  sac  has  been  reached.  The  trochar  is  now  with- 
drawn and  the  fluid  allowed  to  flow  from  the  cannula  until  there  is 
presumably  some  risk  of  the  introduction  of  air,  \Yhen  the  brass 
piece  is  to  be  applied  and  the  remainder  drawn  off  with  the 
syringe  or  aspirator.  As  a  substitute  for  the  aspirator  a  caout- 
chouc tube,  eighteen  inches  long,  put  on  the  cannula  or  needle 
and  having  its  lower  end  plunged  in  a  solution  of  boric  acid 
will  prevent  the  entrance  of  germs.  A  prob  has  often  to  be 
introduced  to  prevent  plugging  of  the  cannula  by  floating 
false  membranes,  and  a  new  puncture  in  a  different  place 
may  be  necessary.  In  the  case  of  excessive  accumulation 
it  is  often  advisable  to  draw  it  off  at  two  operations,  as  recom- 
mended in  large  abscess  of  the  pleura  and  for  the  same  reasons. 
The  need  for  such  a  precaution  will  be  understood  when  it  is 
stated  that  in  bad  cases  the  chest  contains  as  much  as  six  or  seven 
ordinary  .stable  bucketfuls  of  the  liquid.  If,  however,  it  is  lim- 
ited in  amount  it  ma^'  be  all  withdrawn  at  once. 


Hydrothorax.  263 

The  most  successful  cases  in  the  horse  have  been  upon  young, 
vigorous  animals,  from  four  to  eight  years  old,  during  the  first 
month  of  illness,  and  where  the  pleurisy  has  been  confined  to  one 
side. 

Dr.  Bowditch  lays  down  the  following  rules  for  the  adoption  of 
paracentesis  in  man  {Clinical  Medicine,  by  Prof.  W.  T.  Gaird- 
ner)  : — 

' '  I  now  never  operate  unless  I  find  some  distension  or  rounding 
out  of  the  chest,  and  filling  up  of  some  of  the  intercostal  spaces, 
so  that  the  chest  presents  a  uniform  curve,  and  not  alternate  de- 
pressions and  elevations  as  in  the  healthy  chest.  I  operate  under 
the  following  circumstances  when  I  feel  certain  there  is  fluid  : 

"  I.  When  there  is  severe  permanent  dyspiicea — orthopnoea — 
however  acute  the  disease  if  I  find  fluid  filling  the  pleural  cavity, 
or  nearly  filling  it. 

"2.  When  there  are  occasional  attacks  of  orthopnoea  threaten- 
ing death,  even  if  there  be  not  sufficient  to  fill  more  than  half  of 
the  cavity.  If  the  fluid  seems  to  be  the  cause  of  the  dyspnoea  I 
operate,  because  occasionally  I  have  lost  -a  patient  while  waiting 
for  more  extensive  physical  signs.  This  rule  I  apply  to  acute  and 
chronic  cases. 

"  3.  I  use  the  trochar  after  three  or  four  weeks  of  ineffectual 
treatment,  without  any  absorption  being  produced. 

"  4.  In  chronic  idiopathic  hydrothorax,  a  latent  pleurisy  with 
simply  physical  signs  to  indicate  extensive  effusion,  but  when  the 
rational  signs  are  either  very  slight  or  none  at  all  save  a  general 
malaise  and  weakness." 

The  use  of  iodide  of  potassium  and  vegetable  and  mineral 
tonics  must  be  perseveringly  employed  and  the  strength  further 
supported  by  a  generous  diet,  to  secure  the  animal  against  the 
dangers  of  extreme  prostration,  of  suppuration,  or  other  undesira- 
ble conditions  of  the  exuded  product. 

Among  the  dangers  attending  thoracentesis  are  fainting  as  a 
result  of  shock  on  the  sudden  withdrawal  of  so  much  liquid, 
rupture  of  the  false  membranes,  and  even  of  the  enclosed  lung 
tissue  or  of  blood  vessels,  under  the  sudden  expansion  of  the  par- 
tially collapsed  lung  confined  by  the  investing  false  membrane, 
and  the  introduction  of  pus  or  septic  germs  into  the  pleural  cavit3^ 
To  obviate  the  first  named  dangers  tight  bands  (circingles)  around 


264  Veteri7iary  Medicine. 

the  chest  will  give  support  and  limit  sudden  expansion.  In  case 
of  excess  of  liquid  the  withdrawal  of  one-half  or  two-thirds  at 
a  time  will  allow  opportunity  for  accommodation.  Haemorrhage 
may  be  met  by  the  internal  use  of  chloride,  sulphate  or  nitrate  of 
iron,  matico,  hamamelis  or  tannic  acid,  and  a  weak  solution  of 
boric  acid  or  other  antiseptic  agent  may  even  be  injected  in  small 
amount  into  the  pleural  cavity. 

In  obstinate  and  chronic  cases  the  injection  of  a  weak  solution 
of  iodine  and  iodide  of  potassium  is  often  of  service.  In  other 
cases  a  normal  chloride  of  sodium  solution  (previously  sterilized) 
may  be  introduced  as  soon  as  a  partial  evacuation  causes  uneasi- 
ness, and  by  a  succession  of  such  evacuations  and  injections  the 
residuum  liquid  may  be  rendered  clear  and  largely  aseptic  on  a 
single  occasion. 

In  the  smaller  animals  the  selection  of  the  most  dependent  part 
for  insertion  of  the  trochar  is  not  so  essential,  as  the  body  may  be 
turned  to  facilitate  the  drainage. 

On  completion  of  the  operation  the  wound  may  be  again  treated 
antiseptically  and  coated  with  aristol  or  collodion. 


PNEUMOTHORAX.     AIR  OR  GAS  IN  THE  PLEURA. 

Causes,  decomposition  of  liquid  effusion,  perforation  from  a  bronchium, 
the  stomach,  a  thoracic  wound.  Symptoms,  metallic  tinkling,  splashing, 
succussion,  drum-like  resonance,  suppressed  respiratory  murmur,  distance 
of  cough  sound,  distress,  anxiety,  dyspnoea,  bulging  intercostal  spaces, 
sometimes  a  wound.  Treatment,  closure  of  wound,  calmatives,  aspiration 
of  gas.     Treatment  for  pleurisy. 

The  collection  of  air  or  gas  in  the  cavity  of  the  pleura  has  al- 
ready been  noticed  as  co-existing  with  liquid  effusion  in  some 
cases  of  advanced  pleurisy.  It  may  arise  from  other  causes, 
among  which  may  be  noted  :  i.  When  a  mass  of  pulmonary 
tubercle  connected  with  a  bronchial  tube  has  opened  into  the 
pleural  sac.  2.  When  a  communication  has  been  established  be- 
tween the  pleural  cavity  and  the  alimentary  canal,  as  in  combined 
rupture  of  the  stomach  and  diaphragm,  or  of  the  double  colon  and 
diaphragm.  3.  When  a  rib  is  fractured  and  the  broken  end  pen- 
etrates the  lung  tissue  and  opens  into  one  or  more  small  bronchial 
tubes.  4.  When  a  wound  has  been  inflicted  penetrating  the  walls 
of  the  chest  and  forming  a  valvular  orifice  through  which  air  is 
drawn  inward  during  each  inspiratory  act,  but  out  of  which  it 
cannot  pass  when  the  thorax  collapses. 

The  amount  of  gas  present  may  be  extremely  slight,  or  in  a 
case  such  as  that  from  a  valvular  wound  it  may  cause  complete 
collapse  of  the  lung,  falling  up  the  entire  half  of  the  thorax  and 
bulging  into  the  opposite  half. 

The  symptoms  are  often  very  obscure.  If  with  liquid  the  me- 
tallic tinkling  after  rising,  in  small  animals  the  splashing  when 
shaken  and  the  other  sounds  of  auscultation  and  percussion  will 
point  it  out  as  described  under  pleurisy.  In  the  case  of  a  broken 
rib  the  distortion,  swelling  and  tenderness,  will  lead  to  suspicion. 
A  penetrating  sound  will  be  sufficiently  evident,  and  in  the  case 
of  tubercle  previous  cough  and  ill-health  will  have  been  manifest. 

The  specific  signs  of  uncomplicated  pneumothorax  are  :  ist,  A 
drum-like  resonance  on  percussion  over  the  seat  of  the  gas, 
usually  at  the  upper  part  of  the  chest ;  2d,  A  partially  suppressed 
or  distant  respiratory  murmur  over  the  same  area  ;  3d,  A  muffled 
or  suppressed  sound  of  thecough  ;  4th,  Sometimes,  especially  if  the 

265 


266  Vetermary  Medicine. 

gas  is  abundant,  prominence  of  the  chest  on  that  side  ;  5th,  There 
are  also  more  or  less  distress  and  anxiety,  difficult  breathing,  quick, 
weak,  rapid  pulse,  and  other  signs  of  illness. 

Some  cases  of  this  kind  recover  spontaneously  or  with  the 
liquid  effusion  with  which  they  are  associated  ;  in  traumatic  cases 
the  wound  is  sometimes  sealed  up  by  a  pleuritic  exudation  which 
here  becomes  a  curative  process  ;  while  in  some  examples  of  val- 
vular wound  of  the  lung  or  walls  of  the  chest  death  may  ensue 
in  a  period  varying  from  a  few  minutes  and  upwards  to  weeks. 

Treatment  is  limited  to  the  prevention  of  the  ingress  of  air 
through  an  external  wound  where  that  exists  ;  the  employment  of 
opiates  and  other  agents  to  moderate  attendant  suffering  ;  to 
measures  calculated  to  moderate  the  intensity  of  resulting  pleu- 
risy, and,  in  cases  where  there  is  imminent  danger  from  accumu- 
lation of  gas,  to  the  puncture  of  the  chest  and  the  careful  withdrawal 
of  the  gas  by  aspiration.  If  necessary  sterilized  air  may  be 
made  to  replace  the  aspirated  gas. 


PYO-PNEUMOTHORAX,  EMPYEMA. 

Causes,  septic  cocci  entering  through  wound  or  blood.  Symptoms,  those 
of  hydrothorax,  with  prostration,  fcetor,  and  it  may  be  issue  of  pus. 
Treatment  by  antiseptic  injections. 

A  purulent  fluid  in  the  pleural  cavity  may  be  found  in  ordinary 
pleurisy,  but  is  much  more  likely  to  supervene  in  traumatic  forms, 
in  which  the  pus  cocci  reach  the  cavity  through  the  wound  of  the 
bronchia,  alimentary  canal,  or  chest  walls. 

The  symptoms  are  essentially  those  of  pneumothorax,  with 
greater  prostration,  and  in  certain  cases  a  distinct  feverish  smell 
or  fcetor  of  the  breath,  or  the  escape  of  pus  through  a  wound. 
In  treatment  the  difference  from  pneumothorax  is  mainly  in  the 
antiseptic  character  of  the  injections  and  the  freer  emploj^ment 
of  stimulants  and  tonics.  Salt,  salicylic  acid,  borax,  peroxide 
of  hydrogen,  aluminium  acetate,  or  potassium  permanganate  so- 
lutions may  be  used.  Tonics  (quinia)  and  antiseptics  (sulphites, 
salicylates,  iron)  may  be  given. 


CHRONIC  PLEURISY. 

Animals  liable.  Causes,  irritation  through  effusion  and  exudate  acting  on 
susceptible  pleura,  or  by  other  disease  products  in  lung  or  pleura.  Unhy- 
gienic surroundings  and  management  predisposes.  Frequent  chills  in  cold 
water.  Symptoms,  unthriftiness,  easily  blown,  fatigued,  or  sweated,  cough, 
paroxysmal  under  exertion,  pallor  of  mucous  membranes  becoming  congest- 
ed on  slight  exertion,  difficult  breathing  when  recumbent,  percussion  and 
auscultation  signs  of  pleurisy  and  hydrothorax.  Lesions,  great  liquid  effu- 
sion, clotting  on  exposure,  with  much  albumen  and  cell-forms.  False 
membranes  partially  organized.  Treatment,  tonic,  diuretic,  derivative, 
diet  nourishing,  counterirritants,  paracentesis. 

In  all  domestic  animals  acute  pleurisy  may  merge  into  the 
chronic  form,  the  irritation  being  maintained  by  the  presence  of 
the  residuum  liquid  and  the  false  membranes  and  adhesions  which 
interfere  with  the  free  dilatation  of  the  chest.  The  pleura  too, 
having  been  once  inflamed,  retains  an  increased  susceptibility  to 
such  disturbing  conditions.  In  other  cases  the  affection  is  sympto- 
matic of  other  chronic  affections,  as  tuberculosis,  glanders,  and 
neoplasms  of  various  kinds.  It  has  been  seen  especially  in  old, 
weak  and  debilitated  subjects,  kept  in  confined,  impure  stables  or 
habitually  exposed  to  undue  cold  and  damp.  Hence  dairy  cows 
in  unhygienic  conditions,  and  hunting  dogs,  which  plunge  in  wa- 
ter when  heated,  are  among  the  mo.st  frequent  victims. 

Symptoms  are  often  obscure.  The  affected  horse  may  be  bright 
and  lively,  .showing  little  respiratory  disturbance  unless  under 
exertion.  Yet  there  is  a  general  appearance  of  unthriftiness,  with 
erect,  dry  hair,  hidebound,  and  a  small,  dry  cough.  Under  work 
there  is  hurried  breathing,  early  exhaustion,  ready  perspiration, 
and  aggravation  of  the  cough  which  then  occurs  in  paroxysms. 
Auscultation  and  percussion  give  characteristic  signs  according  as 
there  may  or  may  not  be  false  membranes  or  effusion  at  particu- 
lar points.  It  is  usually  bilateral  in  horses,  unilateral  in  other 
animals. 

In  cows  in  addition  to  the  corresponding  symptoms,  there  is 
pallor  of  the  mucous  membranes  when  at  rest,  quickly  transform- 
ed into  congestion  under  exercise,  suppre.ssion  of  the  milk,  and 
weak  heart  beats  unless  when  excited.     In  the  advanced  condi- 

267 


268  Veterinary  Medicine. 

tion  the  animal  has  difficulty  of  breathing  when  recumbent  on  the 
sound  side  and  subcutaneous  infiltration  is  felt  or  seen  beneath  the 
sternum  or  in 'the  limbs.  The  affected  side  shows  an  increased 
dimension,  vertical  and  longitudinal,  of  the  chest,  and  the  inter- 
costal spaces  in  their  lower  part  bulge  out  and  fluctuate. 

In  cows  and  indolent  animals  there  may  be  a  quiescent  condi- 
tion or  very  slow  progress,  but  any  violent  exertion  is  likely  to 
give  a  sudden  stimulus  to  the  morbid  process. 

Lesions.  The  liquid  effusion,  usually  unilateral,  except  in  the 
horse  may  amount  to  40  quarts  in  the  latter  animal,  30  quarts  in 
the  ox  (Rigot),  and  5  to  6  quarts  in  the  dog.  Unless  there  has 
been  a  recent  sudden  accession  of  inflammation  it  is  of  a  pale 
straw  color,  with,  in  the  dog,  a  slight  rosj-  tinge.  It  clots  loosely 
on  exposure  to  the  air  and  contains  a  large  amount  of  albumen 
and  few  cell-forms.  The  false  membranes  are  thick  and  white  at 
some  points  and  red  and  vascular  at  others.  In  the  main  they 
are  completely  organized.  The  lung  is  more  or  less  collapsed  and 
the  right  heart  dilated  and  attenuated. 

Treatmejit  must  be  in  the  main  tonic,  diuretic  and  derivative. 
Food  must  be  nourishing,  digestible  and  in  liberal  amount  ;  diur- 
etics and  bitter  tonics  with  digitalis  and,  (if  there  is  little  fever) 
preparations  of  iron  are  to  be  pushed  as  far  as  the  strength  will 
allow  ;  and  the  counterirritants  applied  to  the  sides  of  the  chest  a 
number  of  times  in  succession.  Iodides  may  be  used  internally 
and  externally,  and  paracentesis  must  be  employed  unless  early 
improvement  is  manifested. 


PLEURODYNIA. 

Definition.  Sj'mptoms,  stiffness,  pointing  of  fore  limb,  catching  inspira- 
tion, tender  intercostals,  less  fever,  cough,  and  hardness  of  pulse  than  in 
pleurisy,  no  friction  sound  nor  signs  of  pleuritic  effusion.  Treatment,  anti- 
rheumatic, derivatives,  colchicum,  alkalies,  salicj-late,  salol,  phenacetin, 
warm  (steam)  bath,  warm  building  and  clothing. 

Defijiitlo7i.  Rheumatism  of  the  intercostal  muscles.  This  has 
been  occasional!}'  observed  in  the  horse,  and  is  IJable  to  be  mis- 
taken for  pleuris}',  which  it  closely  resembles  in  its  symptoms. 
There  are  the  same  stiffness  of  the  fore  limb  on  the  affected  .side, 
the  same  short  breathing,  the  same  fixed  and  inactive  appearance 
of  the  ribs,  and  the  same  extreme  tenderness  on  pressure  as  in 
pleurisy  ;  but  the  high  type  of  fever,  the  cough  and  the  full  hard 
and  accelerated  pulse  are  usually  absent  ;  the  tenderness  tends  to 
.shift  from  one  point  to  another,  there  is  no  shivering  nor  friction 
sound  in  the  early  .stages,  and  no  subsequent  absence  of  sound  and 
deadness  on  percussion  over  the  lower  part  of  the  chest  as  result 
from  effusion.  When  associated  with  fever  it  is  ver}^  difficult  to 
distinguish  from  pleurisy,  and  its  recognition  can  only  be  made 
by  these  physical  signs  just  mentioned. 

Treatment.  This  must  be  the  same  as  in  rheumatic  attacks  in 
general.  Rub  the  chest  actively  and  repeatedly  with  a  mixture 
of  equal  parts  of  spirits  of  turpentine,  laudanum  and  olive  oil, 
give  Yz  drachm  doses  of  powdered  colchicum  daily  and  bicarbon- 
ate of  potass  freel)^  in  the  water  drank.  Or  give  four  times  a  day 
2  drachms  of  salicylate  of  soda,  or  i  drachm  of  salol,  or  phena- 
cetin. K  warm  building  and  warm  clothing  are  essential  ele- 
ments in  treatment. 


269 


BRONCHIAL  ASTHMx\  IN  THE  DOG. 

Definition.  Pathology,  neurotic  origin,  bronchial  spasms,  swelling  of 
mucosa,  fibrinous  inflammation  of  bronchioles,  Berkart's  streptococcus,  irri- 
tants formed  in  indigestion,  overfeeding,  inactivity,  plethora,  constipation. 
Symptoms,  obesity,  sluggishness,  recurrent  paroxysms  of  dyspnoea,  hard 
cough,  tense  abdomen,  constipation,  piles,  depilation  of  skin,  tartar  covered 
teeth,  foetid  breath.  Retching,  vomiting,  a  glairy  mucus,  emaciation  may 
follow.  Lesions,  emphysema,  fatty  deposits  in  mediastinum,  old  standing 
diseases  of  the  heart,  lungs  and  digestive  organs.  Treatment,  antispas- 
modics by  lungs  or  rectum,  stramomium,  nitre  fumes,  emetic,  purgatives, 
vegetable  diet,  exercise,  sedatives,  blisters.    Asthma  in  the  horse. 

Definitio7i. — A  neurotic  affection  mainly  affecting  the  pneumo- 
gastric  nerve,  and  leading  to  paroxysms  of  stenosis  or  constric- 
tion of  the  bronchioles  and  attacks  of  dyspnoea.  In  its  initial 
.stages  it  is  associated  with  corpulence  and  disordered  digestion, 
and  later  with  congestion  and  swelling  of  the  mucosa  of  the 
bronchioles,  emphysema,  and  dilatation  of  the  right  side  of  the 
heart. 

Pathology:  Asthma  is  generally  attributed  to  spasm  of  the 
bronchial  mu.scles  (Williams),  and  though  recent  observations 
have  failed  to  sustain  this  it  must  be  admitted  that  in  the  majori- 
ty of  cases  it  is  of  decided  neurotic  origin.  Again  it  is  attributed 
to  erythematous  swelling  in  patches  of  the  bronchial  miicosa, 
(Clark).  Another  theory  is  that  it  is  a  fibrinous  inflammation  of 
the  mucosa  of  the  bronchioles,  the  tenacious  exudate  blocking  the 
tubes  more  or  less  completely  and  relief  coming  with  a  more 
diffluent  secretion.  Berkart  found  a  streptococcus  in  the  sputa 
which  he  supposed  to  be  the  final  cause.  Again  it  has  been  held 
to  depend  on  the  circulation  in  the  blood  of  deleterious  matters 
introduced  during  digestion.  Again  it  has  been  attributed  to  a 
neurosis  roused  by  constipation  and  the  accumulation  of  irritant 
matters  in  the  intestine.  Whatever  local  conditions  ma}^  be 
operative,  there  can  be  no  doubt  that  in  dogs  it  is  almost  exclu- 
sively confined  to  those  kept  indoors,  overfed,  without  exercise, 
plethoric  and  con.stipated.  The  disease  seems  to  originate  in  and 
persist  by  nervous  disorder  propagated  from  the  digestive  organs. 
270 


Bronchial  Asthma  in  the  Dog.  27  r 

A  change  of  diet  or  any  disturbing  cause  may  bring  on  a  par- 
oxysm. 

Symptoms.  The  disease  is  one  of  pet  dogs,  kept  in  towns,  de- 
prived of  exercise,  fresh  air,  and  of  the  opportunity  to  relieve  the 
bowels  at  will,  and  gorged  with  highly  spiced  meats,  and  sweets 
at  least  three  times  a  day.  Sluggishness  and  obesity  are  marked 
characteristics  of  the  dog  when  first  attacked  though  in  the  ad- 
vanced stages  the  violence  of  the  paroxj'sms  and  their  frequent 
recurrence  may  have  induced  extreme  emaciation. 

The  affection  is  usually  ushered  in  by  a  cough,  at  first  slight, 
but  soon  becoming  frequent,  hard  and  sonorous,  as  in  the  early 
stages  of  bronchitis.  The  cough  becomes  very  troublesome  and 
the  breathing  habitually  labored,  but  at  irregular  intervals  a 
paroxysm  comes  on  which  threatens  death  by  suffocation.  The 
dog  stands  or  sits  on  his  haunches  with  open  mouth,  pendent 
tongue  and  staring  eyeballs,  panting  for  breath,  and  has  his  con- 
dition aggravated  by  every  change  of  position  or  other  source  of 
excitement.  By  the  frequency  and  severity  of  the  attacks  may 
be  estimated  the  danger  of  the  patient. 

An  examination  in  the  intervals  of  the  attacks  detects  some 
disturbance  of  the  digestive  organs.  The  tense  and  distended 
condition  of  the  abdomen  usually  manifests  the  existence  of  over- 
loaded stomach  and  bowels,  of  indigestion,  tympany  and  consti- 
pation. Piles  are  often  present  as  a  result  of  long  continued 
costiveness.  The  skin  is  dry  and  unthrifty,  and  often  in  patches 
denuded  of  hair.  The  teeth  are  covered  with  tartar  and  the 
breath  foetid. 

Retching  is  occasionally  seen  to  occur  during  a  violent  access 
of  coughing,  but  only  a  little  glairy  mucus  is  brought  up. 

The  cough,  hurried  breathing,  and  paroxysms  of  dyspnoea  be- 
come aggravated,  the  general  health  suffers  largely,  and  death 
often  ensues  in  a  state  of  great  weakness  and  emaciation. 

On  dissection  of  such  cases  the  lesions  of  various  old  standing 
diseases  of  the  heart,  lungs,  or  abdominal  organs  have  been  met 
with  at  times,  and  such  disorders  have  doubtless  a.ssisted  in  main- 
taining and  aggravating  the  asthma.  The  mo.st  constant  lesions, 
however,  are  emphysema  of  the  lung,  and  accumulations  of  fat 
in  the  mediastinum. 

Treatment,     ist.   During  a  paroxysm.     This  is  confined  to 


272  Veterinary  Medicine. 

the  administration  of  antispasmodics  either  by  inhalation  or  as 
an  injection  to  avoid  the  additional  suffering  of  swallowing. 
Ether  or  chloroform  may  be  inhaled  from  a  sponge,  but  the  em- 
ployment of  these  should  be  guarded  especially  in  advanced  cases 
when  besides  the  prevailing  weakness  there  is  reason  to  suspect 
structural  changes  in  the  heart.  The  same  agents  in  doses  of 
one,  two  or  three  teaspoonfuls,  or  laudanum  in  double  that 
quantity  may  be  thrown  up  as  an  enema,  and  may  be  combined 
with  a  couple  of  ounces  of  castor  oil  when  costiveness  exists. 
The  fumes  from  burning  stramonium  or  from  burning  brown  pa- 
per which  has  been  previously  soaked  in  a  strong  solution  of  nitrate 
of  potass,  will  in  many  cases  suddenly  cut  short  the  paroxysm.  If 
on  the  other  hand  there  is  reason  to  believe  that  the  stomach  is 
overloaded  the  attacks  will  often  be  suddenly  cut  short  by  giving 
an  emetic.  For  this  purpose  a  grain  of  tartar  emetic  may  be 
shaken  upon  the  tongue,  or  a  dessert  spoonful  of  wine  of  ipeca- 
cuan,  or  of  antimony,  poured  over  the  throat.  2d.  In  the  in- 
tervals between  the  paroxysms.  Attention  must  be  given  to 
counteract  any  inflammatory  action  in  the  chest  by  which  the 
disease  may  be  maintained.  Our  chief  object,  however,  must  be 
to  divest  the  animal  of  its  superfluous  fat  and  bring  the  digestive 
organs  into  a  healthy  condition.  Unfortunately  the  propensity  to 
fatten  in  some  dogs  seems  to  be  a  morbid  condition.  The  food 
appears  to  be  stored  up  as  fat  at  the  expense  of  muscular  and 
other  tissues  even  when  the  animal  is  kept  on  the  borders  of  star- 
vation. All  flesh  must  be  withheld  and  coarse  vegetable  fare 
alone  allowed.  A  well  boiled  pudding  (porridge)  made  with  oat- 
meal or  Indian  corn  meal,  water  and  a  little  salt,  with  a  small 
quantity  of  skimmed  milk  or  buttermilk,  is  an  excellent  diet  in 
such  cases.  The  amount  must  be  small,  though  the  hitherto 
pampered  favorite  will  rarely  seek  to  fully  replenish  his  stomach 
until  he  has  forgotten  his  former  extravagant  habits. 

A  good  deal  of  open  air  exercise  must  be  given,  not  violent, 
but  gentle  and  long  continued,  and  this  though  the  patient  may 
appear  physically  unfit  for  it.  Exercise  should  be  given  three 
hours  or  more  after  a  full  meal.  Purgatives  (one  ounce  castor 
oil)  should  be  administered  twice  a  week.  A  clean  bed,  not  too 
soft  nor  luxurious,  should  be  allowed  in  a  dry,  airy  place.  The 
skin  should  be  well  brushed  daily  and   occasionally  washed  thor- 


Bronchial  Asthma  in  the  Dog.  273 

oughly  with  soap,  care  being  taken  to  dry  the  coat  completely 
afterwards.  Sedatives  should  be  giv^en  daily,  such  as  a  half  grain 
each  of  stramonium  and  tartar  emetic,  and  in  advanced  stages 
with  weakness  and  emaciation  vegetable  tonics  will  be  demanded. 

Blaine  strongly  advocates  a  course  of  emetics,  given  every 
alternate  day,  and  Mayhew  lauds  frequently  repeated  ammoniacal 
blisters  to  the  sides.  Such  measures  will  be  especially  applicable 
when  there  is  irritation  and  discharge  from  the  bronchial  mucous 
membrane.  Strong  subjects  can  alone,  however,  bear  such  treat- 
ment. 

All  cases  of  asthma  in  the  dog  are  obstinate  and  critical  and 
require  much  judgment  in  treatment. 

ASTHMA    IN   THE   HORSE. 

Hering  records  a  case  of  spasmodic  asthma,  in  a  strong  cart 
horse.  Besides  the  oppressed  and  difficult  respiration,  the  animal 
was  excessively  dull  and  had  no  appetite,  but  the  pulse  was  al- 
most of  the  natural  standard.  The  animal  was  not  benefited  by 
opening  medicine  but  improved  under  active  doses  of  extract  of 
hyoscyamus.  Quillaume  reports  two  asses  attacked  apparently 
in  the  same  way,  and  Del  wart  and  Robertson  refer  to  other 
cases.  They  recovered  under  antispasmodics.  These  are  at 
least  closely  related  to  heaves,  which  is  largely  a  neurosis  at  first. 


ASTHMA.     BROKEN  WIND.     HEAVES.     DYSPNCEA. 

Definition,  nenrotic  affectiou  with  digestive  and  respiratory  disorders. 
Causes,  no  racial  exemption,  disease  largely  coextensive  with  leafy  hay 
from  clover,  alfalfa  and  other  leguminous  plants,  musty  hay,  cryptogams, 
overloading  the  stomach,  active  work  on  a  full  stomach,  overdriving,  bron- 
chitis, chronic  bronchitis,  emphysema.  Nature,  a  neurotic  affection,  start- 
ing with  derangement  of  some  part  of  the  vagus,  dilatation  of  the  right 
heart,  congestion  of  the  bronchioles.  Symptoms,  double  expiratory  action, 
flatulence,  weak,  husky  cough,  wheezing,  glairy,  grayish  nasal  discharge, 
wheezing,  increased  resonance  along  the  margins  of  the  lungs,  sibilant 
rale,  heart's  impulse  strong,  even  felt  on  right  side,  aggravation  with  over- 
loaded stomach,  costiveness  or  muggy  atmosphere,  improvement  on  laxa- 
tive (green)  food.  Treatment,  succulent  green  food,  natural  pastures,  re- 
lieve any  abnormal  state  of  lungs  or  bowels,  pure  air,  heart  tonic,  diet, 
arsenic,  special  diagnosis,  guard  against  masking  of  symptoms  by  narcotics, 
privation  of  water,  shot,  lard,  recto-vaginal  fistula,  diagnostic  signs,  dilated 
nostrils,  auscultation  and  percussion  signs  of  emphysema,  relapse  under 
hay  and  water. 

Definitioyi.  A  chronic  affection  of  the  equine  species,  mani- 
fested by  a  hurried,  wheezy  breathing,  greatly  aggravated  by 
close,  muggy  weather,  a  full  stomach,  certain  kinds  of  diet,  or 
by  exercise  ;  by  a  double  lifting  of  the  flank  with  each  expira- 
tion ;  by  a  small,  weak,  dry  cough,  often  occurring  in  paroxysms 
and  easily  excited  by  a  drink  of  cold  water,  exposure  to  cold  air 
or  a  fibrous  quality  of  food  ;  and  lastly,  by  a  marked  dii:order  of 
the  digestive  organs. 

Causes.  This  disease  is  essentially  the  result  of  faulty  feeding 
and  working,  though  preexisting  diseases  of  the  air  passages  and 
sudden  violent  muscular  efforts  no  doubt  occasionally  contribute  to 
its  development. 

It  has  been  alleged  that  some  races  of  honses  are  exempt  from 
this  disease.  Among  these  the  Arabian,  Persian,  Barb,  Spanish 
and  Portugese  are  especially  named  but  their  immunity  in  all  prob- 
ability depends  on  the  feeding  and  management  rather  than  on  any 
peculiarity  of  breed.  The  countries  where  these  horses  are  met 
with  are  not  subject  to  a  prolonged  winter  but  yield  green  food 
throughout  the  greater  part  of  the  year,  and  it  is  a  notorious  fact 
■that  no  horse  becomes  brokenwinded  at  pasture.  The  Arabians 
274 


Asthma.     Broken   Wind.     Heaves.     Dyspnea.  275 

moreover  ' '  feed  their  horses  011  the  scanty  plants  which  the  bor- 
ders of  the  deserts  supply  and.  when  these  are  wanting  they 
are  fed  on  a  little  barley  with  chopped  straw,  withered 
herbs,  roots  dragged  from  the  sands,  dates  when  these  can 
be  obtained,  and  in  cases  of  need  the  milk  of  the  camel.  They 
drink  at  long  intervals  and  in  moderate  quantities,  "  (I,ow). 
Since  an  habitually  overloaded  stomach  is  the  most  common  cause 
of  heaves  the  absence  of  the  affection  in  the  Arab  is  not  surprising. 
But  the  Arab  unfortunately  enjoys  no  such  security  in  England  or 
America.  Concerning  the  Barb,  Delwart  remarks  that  after  a 
day's  hard  work,  fasting,  he  is  fed  on  six  or  seven  pounds  only 
of  barley,  and  without  the  cut  straw  that  the  Arab  is  allowed  in 
similar  circumstances. 

In  Spain  and  Portugal  horses  at  work  are  fed  on  broken  wheat 
and  barley  straw,  from  twelve  to  twenty-five  pounds,  and  barley 
from  six  to  twelve  pounds  daily,  according  to  the  size  of  the  ani- 
mal and  the  demands  upon  his  strength.  The  mares  are  constant- 
ly'- at  pasture  and  according  to  the  rainfall  they  are  starved  or  in 
abundance.  Green  food  and  a  limited  straw  and  grain  diet  are 
precisely  the  conditions  in  which  broken  wind  does  not  appear. 
Rodriguez,  veterinarian  to  the  queen  says  that  the  disease  was 
unknown  to  Spain  until  the  cultivation  of  red  clover,  lucerne,  and 
sainfoin.  At  Aranjuez,  horses  fed  on  the  hay  of  these  plants, 
lost  vigor  and  wind  and  several  became  decidedly  broken  winded. 
All  were,  however,  restored  to  health  and  vigor  by  a  return  to 
their  former  diet.  Count  Cardenas  found  that  his  horses  gained 
in  flesh  on  the  new  fodder,  but  that  symptoms  of  broken  wind 
developed  themselves  rapidly. 

In  France,  M.  Demoussy  records  similar  facts.  In  Segala, 
where  the  aliment  is  substantially  haj-,  broken  winded  horses 
abound,  whilst  in  the  adjacent  district  of  Causse  where  horses  are 
fed  through  the  winter  on  straw  and  barley  broken  by  the  mules 
feet  in  the  act  of  threshing  or  treading  out,  the  disease  is  virtually 
unknown. 

lyucerne  and  sweet  trefoil  are  indigenous  and  grow  abundantly 
in  Causse  and  Caussergne  but  eaten  green  or  after  their  seed  has 
been  shaken  off  and  the  stems  have  acquired  a  dry  ligneous  char- 
acter these  are  innocuous.  When  however  condemned  to  stand 
in  the  stable  through  a  severe  winter,  with  their  racks  constantly 


276  Veterinary  Medicine. 

filled  with  hay,  the)^  will  eat  from  thirty  to  thirty-five  pounds  of 
this  daily  and  many  become  brokenwinded.  The  breeding  mares 
which  get  little  hay,  seldom  become  affected  though  the  plenitude 
of  their  abdomen  and  the  impaired  respiratory  function  might  be 
thought  to  conduce  to  the  affection. 

In  England  broken  wind  is  much  less  prevalent  than  on  the 
European  Continent  and  it  is  deserving  of  notice  that  lucerne  and 
sainfoin  hold  no  place  among  the  British  green  crops,  that  red 
clover  hay  is  only  exceptionally  met  with  owing  to  the  amount  of 
land  that  is  clover-sick,  that  natural  hay  is  largely  used,  and  that 
when  horses  are  largely  fed  on  hay  it  is  qualified  by  such  laxative 
agents  as  turnips,  carrots,  beet,  etc. 

All  this  throws  light  on  the  innnunity  of  horses  on  our  western 
prairies  and  plains.  Feeding  on  the  indigenous  grasses  fresh  or 
made  into  hay,  they  are  saved  from  the  noxious  influence  of  those 
artificial  products  which  are  found  in  all  countries  to  determine 
the  development  of  broken  wind.  It  needs  not  that  we  adopt 
the  popular  notion  that  any  special  plant  growing  in  these  pas- 
tures ensures  the  safety  of  the  equine  races.  It  is  merely  a  repe- 
tition in  the  Western  Hemisphere  of  the  experience  so  long  before 
obtained  in  the  case  of  Spain.  Parallel  with  the  progress  of  cul- 
tivation in  our  western  lands,  we  see  this  malady  advancing. 
Fifty  years  ago  it  was  virtually  unknown  in  Michigan  and  adja- 
cent states  whereas  now  these  states  can  almost  emulate  New 
York  in  the  relative  number  of  their  victims.  It  must  not  how- 
ever be  supposed  that  this  cultivated  fodder  is  the  sole  cause  of 
the  westward  march  of  this  malady.  With  improved  agriculture 
have  come  better  roads,  spring  wagons  and  driving  at  a  pace 
which  was  comparatively  unknown  to  the  early  settlers. 

In  California  the  condition  of  Spain  was  for  long  pretty  accur- 
ately repeated.  With  no  winter  worthy  of  the  name,  troops  of 
horses  were  left  at  pasture  throughout  the  whole  year  and  those 
that  were  stabled  subsisted  chiefly  on  natural  hay  in  which  the 
indigenous  grasses  were  commingled  with  white — but  no  red — 
clover.  California  long  retained  the  reputation  of  having  no 
broken-winded  horses. 

In  our  Eastern  states  where  the  disease  was  thirty  years  ago  so 
notoriously  prevalent,  the  fields  of  luxuriant  red  clover  might  well 
have  excited  the  envy  of  the  English    farmer.     The  hay  made 


Asthma.     Broken   Wind.     Heaves.     Dyspnoea.  277 

from  this,  full  of  seed  and  dust  was  given  without  stint  to  the 
farm  horses,  which  during  the  rigor  of  the  winter  were  often  shut 
up  in  stable  for  a  length  of  time  continously  and  dangerously 
gorged  themselves  with  this  provender.  In  the  Eastern  States 
with  a  steady  falling  off  in  the  red  clover,  there  is  also  a  corres- 
ponding reduction  in  the  number  of  cases  of  heaves.  The  grain 
allowed  them,  a  mixture,  supposed  to  consist  of  Indian  corn,  oats 
and  buckwheat,  given  as  a  dry  coarse  flour,  was  little  calculated 
to  counteract  the  effects  of  the  clover  haj^  and  the  entire  absence 
of  turnips  and  other  succulent  roots  as  a  farm  crop  precluded  their 
use  as  a  preventive  of  the  nlalad3^  We  need  not  forget  the 
prevalent  ambition  to  possess  a  fast  trotter,  nor  the  effect  of  the 
climate  on  the  air-passages  (See  chronic  bronchitis)  in  estimating 
the  causes  of  this  malady  in  the  Eastern  states. 

The  mere  overloading  of  the  stomach  is  a  potent  cause  of  the 
development  of  heaves.  The  horse  is  above  all  other  animals 
compelled  to  undergo  hard  work  on  a  full  stomach.  Coleman 
cites  the  experience  of  the  coaching  days  when  each  horse  had 
20  lbs.  of  oats  daily  and  not  more  than  5  lbs.  of  hay  with  no  water 
before  work.  These  horses  were  driven  fast  for  long  stages  yet 
they  never  contracted  broken  wind  under  this  treatment.  Farm- 
ers' and  millers'  horses  on  the  other  hand  were  most  subject  to 
the  disease  because  gorged  continually  with  hay  chaff  and  mealy 
food,  and  worked  in  this  condition.  "  Nimrod"  who  confirms 
Coleman's  statement  says  "  I  have  taken  some  pains  to  ascertain 
this  fact  by  my  own  personal  inquiries.  One  proprietor  who  has 
nearly  fifty  horses  at  work — many  of  which  are  in  as  fast  coaches 
as  any  that  travel  on  the  road — assured  me  lately  that  he  had 
not  a  broken-winded  horse  in  his  yard  ;  whereas  before  he  stinted 
them  in  their  hay  he  generally  had  one  to  five  in  that  state." 
Percivall  testifies  to  its  comparative  infrequency  in  the  English 
cavalry  horses,  which  have  their  diet  carefully  regulated.  Hay 
musty  from  bad  harvesting  or  other  cause  and  such  as  is  rank 
from  growing  in  low  wet  localities  are  caeteris  paribus  more  in- 
jurious than  good  hay. 

Every  day  observation  shows  that  driving  a  horse  upon  a  full 
stomach  often  causes  broken-wind  and  nothing  will  more  surely 
aggravate  it,  when  it  does  exist.  The  same  remark  may  be  made 
of  the  drinking  of  large  quantities  of  water  after  feeding  and  just 


278  Veterinary  Medicine. 

before  going  to  work.  Gross  feeders  are  above  all  others  the  sub- 
jects of  the  complaint. 

The  question  arises  how  a  disturbing  cause  operating  directly 
upon  the  digestive  organs  should  affect  the  respiratory,  in  such  a 
marked  and  permanent  manner.  It  cannot  be  because  of  the 
gastric  and  abdominal  distension  since  pregnant  mares  though  in 
a  state  of  much  greater  plentitude,  are  not  thereby  rendered 
liable  to  broken  wind,  and  if  they  have  previously  suffered  from 
this  infirmity,  the  symptoms  are  usually  less  marked  when  breed- 
ing. The  explanation  first  advanced  by  Dupuy  appears  to  be  the 
correct  one.  The  lungs,  the  stomach,  and  certain  other  organs 
derive  innervation  from  the  vagus  nerve,  and  certain  disturbances 
of  the  stomach  and  intestines  so  impair  the  function  of  this  nerve 
that  the  lungs  are  affected,  at  first  functionally  and  afterwards 
structurally.  In  support  of  this  view  is  the  fact  that  broken 
wind  is  usually  associated  quite  as  much  with  digestive  as  respira- 
tory derangement.  The  horse  though  a  heavy  feeder  becomes 
unthrifty,  hidebound  and  emaciated  ;  his  dung  is  passed  in  an 
undigested  state  like  so  much  chopped  straw,  and  flatus  is  con- 
tinually passed  from  the  bowels.  Indeed  the  almost  incessant 
passage  of  wind  and  faeces,  during  the  first  mile  or  two  of  a  jour- 
ney, is  a  disgusting  evidence  of  the  malady.  The  power  of 
doses  of  shot,  fat  and  other  agents  to  temporarily  allay  the  symp- 
toms may  be  held  to  point  in  the  same  direction. 

Beside  causes  operating  on  the  side  of  the  digestive  organs 
others  undoubtedly  superinduce  the  disease,  and  among  these  se- 
vere exertions  and  chronic  bronchitis  ought  to  hold  prominent 
positions. 

Overexertion  induces  overdistension  and  rupture  of  the  air  cells 
by  the  forced  retention  of  air  within  the  lungs,  bj^  the  closure  of 
the  glottis,  while  the  chest  is  strongly  compressed  by  the  respira- 
tory muscles.  It  is  an  essential  condition  to  all  severe  exertion 
in  man  that  the  breath  should  be  held,  and  though  the  horse  ap- 
pears equal  to  the  same  efforts  of  draught  after  the  operation  of 
tracheotomy  has  deprived  him  of  the  power  of  holding  the  breath, 
yet  he  would  seem  to  be  sooner  exhausted  (Goubaux,  Colin, 
Bouley),  from  which  it  may  be  inferred  that  this  power  is  fre- 
quently exercised,  and  it  probably  always  is  in  any  sudden  severe 
effort  as  in   starting  a  heavy  load,    or  jumping  a  five-bar  gate. 


Asthma.     Broken  Wind.     Heaves.     Dyspnoea.  279 

This  retention  of  air  in  the  hings  during  violent  compression  of 
the  chest  walls  is  precisely  the  condition  met  with  during  an 
access  of  coughing,  and  in  both  cases  alike  there  is  the  tendency 
to  overdistension  of  the  minute  tubes  and  air  cells  until  they  have 
lost  their  power  of  contraction,  or  they  may  even  give  way  and 
allow  the  air  to  pass  out  and  lodge  in  the  lung  tissue. 

Another  mode  in  which  violent  effort  injures  the  lungs  is  by 
the  rapid  and  continued  inhalation  of  great  quantities  of  air  dur- 
ing rapid  breathing,  so  as  to  dilate  the  lungs  suddenly  to  their 
fullest  extent.  Sometimes  from  irregular  distribution  of  the 
serial  current  or  from  the  want  of  tone  in  a  particular  part  of  the 
lung  that  gives  way  under  the  pressure  and  the  air  cells  become 
overdistended  or  ruptured.  This  condition  is  especially  met  in 
the  more  rapid  paces.  It  is  well  exemplified  in  the  results  of  the 
deep  breathing  after  cutting  the  vagi  nerves. 

In  either  case  the  result  will  be  more  certain  if  the  effort  is 
made  upon  a  full  stomach  or  with  the  functions  of  the  vagus 
nerve  impaired  by  a  previous  faulty  diet. 

That  broken  wind  is  a  frequent  concomitant  or  sequel  of 
ehronic  bronchitis  is  undeniable,  and  theoretically  nothing  is  more 
likely  to  cause  dilatation  and  rupture  of  the  air  cells  and  conse- 
quent impairment  of  the  innervation  and  contractility  of  the  lung 
than  violent  fits  of  coughing,  while  the  bronchial  tubes  have 
thickened  and  friable  walls,  or  are  partially  plugged  by  tenacious 
mucus. 

Broken  wind  is  mainly  a  disease  of  old  horses,  though  I  have 
seen  several  cases  in  five-j^ear-old  animals,  and  Bouley  records  a 
case  in  a  two-year-old  colt  out  of  a  badly  broken-winded  mare. 
This  would  seem  to  indicate  an  hereditary  proclivity,  and  there 
is  no  doubt  that  the  shallow,  narrow,  weak  che.st  predisposing  to 
this  as  to  many  other  pulmonary  complaints  is  transmitted  from 
parent  to  offspring. 

Nature  of  the  Disease.  Emphysema  of  the  lungs  is  the  most 
constant  structural  change  met  with  in  the  bodies  of  animals 
which  have  suffered  from  broken  wind.  This  condition  of  the 
horse's  lung  appears  to  have  been  noticed  by  the  early  Greek, 
writers.  It  was  advanced  as  the  cause  of  broken  wind  by  Riding 
in  1704  (Pathologic  Veterinaire),  by  Floyer  in  England  in  1761 
(Treatise  on  Asthma  in  Man),  by  Vitet  in  France  in  1783  (Medi- 


28o  Vetermary  Medicine. 

cine  Veterinaire,  IvVon),  by  Freutzel  in  Germany,  and  Bracy 
Clark  in  England  in  1795.  It  was  only,  however,  after  the  ad- 
mirable discoveries  of  Laennec  that  the  question  was  systematical- 
ly investigated  by  Delafond,  who  has  furnished  the  most  compre- 
hensive data  on  the  subject.  Out  of  fifty-four  broken-winded 
horses  dissected  by  him  no  less  than  forty-five  had  the  lungs 
extensively  emphysematous.  This  emphysematous  lung  differs 
according  to  whether  the  emphysema  is   vesicular  or  interlobular . 

In  vesicular  emphysema  the  smallest  bronchial  tubes  and 
the  air  cells  have  become  distended  beyond  the  natural  standard 
and  remain  permanently  so,  the  lung  tissue  having  lost  its  power 
of  contraction.  If  such  a  lung  is  inflated  and  dried,  and  a  thin 
slice  taken  from  the  surface  of  the  emphysematous  part  the  size 
of  the  minute  orifices  on  the  cut  surface  will  show  its  condition. 
These  fine  openings  are  only  the  air  cells  cut  across,  and  in  their 
healthy  state  the}'  will  admit  no  larger  object  than  the  point  of  a 
needle  or  a  fine  bristle.  They  are  slightly  larger  in  adult  and 
especially  in  old  horses  than  they  are  in  the  young.  If  affected 
by  emphysema  they  will  often  admit  a  hempseed  or  even  a  small 
pea.  On  opening  a  healthy  chest  the  lung  collapses,  contracting 
on  itself  and  expelling  the  contained  air  ;  if  the  lung  is  emphy- 
sematous the  diseased  portion  does  not  collapse  and  if  the  entire 
lung  is  affected  it  continues  to  fill  the  chest  and  may  even  bulge 
outward  after  it  has  been  opened.  The  color  of  the  emphysema- 
tous lung  is  of  a  brighter  red  than  are  the  healthy  portions.  If 
a  diseased  lung  has  been  left  exposed  to  the  air  for  twenty-four 
to  thirty-six  hours  and  then  cut  across  in  all  directions,  the  dis- 
eased lobules  may  be  distinguished  at  a  glance  by  this  lighter 
shade,  and  such  light  portions  if  near  the  surface  will  be  found  to 
correspond  to  elevations  above  the  general  level  of  the  lung.  If 
the  diseased  lung  is  placed  in  water  it  floats  on  the  surface  like 
an  inflated  bladder  scarcely  at  all  sinking  into  the  fluid.  If  the 
lung  is  blown  full  of  air  the  emphysematous  part  is  first  filled 
causing  the  bulging  on  the  surface  to  bs  still  more  marked  than 
before.  Vesicular  emphysema  rarely  affects  an  entire  lung  ;  it 
is  usually  confined  to  the  anterior  lobas  and  to  the  thin  lower 
and  posterior  borders  of  the  organ. 

Interlobular  emphysema  is  the  extravasation  of  air  into  the 
connection  tissue  between  the  lobules  owing  to  rupture  of  the  air 


Asthma.     Broken   Wind.     Heaves.     Dyspna^a.  281 

cells,  and  smaller  bronchial  tubes.  It  may  occur  independently 
of  the  vesicular  emphysema  but  niore  frequently,  it  is  preceded 
by  that  form  and  results  from  it.  It  is  manifested  on  the  surface 
of  the  lung  by  irregularly  formed  tran.sparent  elevations  movable 
from  one  place  to  another  under  the  pressure  of  the  finger  con- 
trary to  what  is  the  case  in  vesicular  emphysema.  These  vary 
from  the  size  of  a  pea  to  that  of  a  hen's  Q^'g.  When  the  air 
exists  in  the  cellular  ti.ssne  between  the  lobules  it  appears  as  in- 
tersecting lines  circuuLscribing  irregular  spans,  and  seemingly 
dark  colored  to  a  superficial  glance  but  seem  to  be  transparent 
on  a  closer  examination.  I^ike  the  elevations  on  the  surface  these 
collapse  on  being  pricked. 

When  a  lung  in  this  state  has  been  inflated  and  dried  it  presents 
on  the  diseased  parts  the  union  of  several  air  .sacs  into  one  by  the 
rupture  of  their  intervening  walls  so  that  a  pea  may  be  lodged  in 
the  cavit}^ ;  it  further  shows  wide  and  prolonged  canals  on  the 
surface  and  in  the  intervals  between  the  lobules — the  dilated 
areolae  of  the  connective  tissue.  These  abnormal  conditions  like 
the  vesicular  emphysema  are  chieflj^  met  within  the  anterior  lobes 
of  the  lungs  along  their  free  borders  and  on  their  inner  surface 
near  the  entrance  of  the  bronchi. 

One  or  both  of  these  two  forms  of  emphysema  may  be  con- 
sidered as  essential  conditions  in  all  forms  of  broken  wind.  It 
does  not  follow  that  this  is  the  primary  disease  ;  we  have  already 
seen  that  the  cause  of  the  malady  is  usually  to  be  sought  on  the 
side  of  the  digestive  organs,  and  that  impaired  innervation,  on 
the  part  of  the  vagus  nerve  or  of  the  ganglia  in  the  brain  presid- 
ing over  it,  leads  to  these  functional  and  structural  changes  in 
the  lungs.  If  these  changes  are  results  and  not  causes,  their  ex- 
tent will  not  necessarily  bear  a  constant  proportion  to  the  intensity 
of  the  disease,  though  in  reality  they  are  generally  found  to  do  so. 

From  a  series  of  injections  of  lungs  from  broken-winded  horses 
M.  Demoussy  arrived  at  the  conclu.sion  that  the  essential  lesion 
of  broken-wind  was  an  aneurismal  dilatation  of  the  capillary  ves- 
sels of  the  lung.  This  is  like  the  condition  of  the  mucosa  found 
in  asthma  in  man  and  is  explainable  in  both  cases  by  the  impaired 
innervation,  as  dilatation  of  these  minute  vessels  is  a  natural  con- 
sequence of  the  loss  of  vaso-motor  nervous  power,  and  contact 
with  air  saturated  with  carbonic  acid. 


282  Veterinary  Medicine. 

Dilatation  of  the  smaller  bronchial  tubes  is  frequentlj^  present 
and  especiall}^  characterises  such  cases  as  supervene  on  chronic 
bronchitis.  These  dilated  tubes  contain  a  plastic,  whitish,  inodor- 
ous mucus. 

Another  frequent  concomitant  of  the  emphysematous  lung  is 
a  dilatation  of  the  right  cavities  of  the  heart,  especially  the  auricle, 
and  an  attenuation  of  their  walls.  The  same  condition  is  noticed 
in  pulmonary  emphysema  in  man  and  like  this  is  probably  due  to 
the  slow  and  imperfect  circulation  in  the  diseased  lung. 

Collating  these  structural  changes  with  the  different  causes  of 
the  disease  we  find  that  they  harmonize  with  the  theory  of  im- 
paired function  on  the  part  of  the  vagus  nerve  or  its  presiding  gan- 
glia, whether  this  functional  disturbance  has  its  origin  in  disorder 
of  the  digestive  organs,  as  in  the  great  majority  of  cases,  in  severe 
muscular  efforts,  or  in  chronic  bronchitis. 

Section  of  the  vagi  nerves  affords  an  exaggerated  instance  of 
their  paralysis  and  its  results.  These  are  mainly  emphysema, 
capillary  dilatation,  blood  extravasation,  inflammation  arid  pul- 
monary collapse.  Emphysema  is  the  first  result  and  due  to  the 
slow,  deep  respiration  (Boddaert)  and  loss  of  contractibility 
(lyonget)  ;  capillar}^  dilatation  results  from  the  extreme  distension 
of  the  air  cells  and  the  retention  in  them  of  air  highly  charged 
with  carbonic  acid  (Bonders)  ;  the  other  lesions  occur  later  and 
own  very  different  causes. 

That  this  is  the  true  nature  of  the  disease  would  further  appear 
from  the  occurrence  of  emphysema  without  broken  wind,  two 
cases  of  which  are  recorded  by  Percivall  ;  and  from  the  existence 
of  broken  wind  without  emphysema.  Cases  of  this  last  variety 
have  been  recorded  by  Godine,  Volpi,  Rodet,  D'Arboval,  and 
Delafond  in  France  ;  and  by  Sewali,  Dick,  Smith,  Hallen  and 
Gloag  in  Britain.  In  connection  with  this  last  class  of  cases  it 
must  be  noted  that  dilatation  of  the  right  cavities  of  the  heart 
sometimes  gives  rise  to  very  similar  symptoms,  and  that  the  signs 
of  chronic  bronchitis  are  often  scarcely  distinguishable  from  those 
of  broken  wind.  In  catarrhal  bronchitis  too,  after  the  air  tubes 
have  been  washed,  it  is  sometimes  impossible  to  decide  whether 
the  lining  membrane  has  been  the  subject  of  inflammation  or  not. 

Syynptoms.  The  most  prominent  are  the  double  lift  of  the  flank 
with  each  expiratory  act,  in  the  absence  of  fever,  the  short,  weak. 


Asthma.     Broken   Wind.     Heaves.     Dyspnoea.  283 

dry  and  almost  inaudible  cough,  the  wheezing  noise  in  breathing 
when  that  is  accelerated  b)'  exertion,  and  the  intestinal  flatulence 
with  the  frequent  passage  of  gas. 

The  cough  usually  heralds  the  advent  of  other  symptoms.  Often 
the  character  of  the  cough  draws  forth  the  remark  that  an  animal 
is  becoming  broken  winded  and  though  no  other  symptom  is  seen 
at  this  time  they  thereafter  rapidly  develop  themselves.  At  this 
early  stage  of  the  disease  the  cough  is  paroxysmal,  coming  on  in 
fits  during  work  or  after  a  drink  of  cold  water.  Once  the  disease 
is  established  the  horse  rarely  coughs  more  than  once  at  a  time. 
The  cough  is  extremely  short,  weak  and  low  and  followed  by  a 
sort  of  wheeze.  So  specific  is  it  that  if  once  heard  it  can  readily 
be  recognized.  The  sudden  effort  made  in  coughing  usually  leads 
to  the  expulsion  of  gas  from  the  flatulent  bowels. 

The  double  lifting  of  the  flank  in  expiration  is  not  peculiar  to 
broken  wind.  It  is  seen  as  well  in  most  diseases  of  the  lungs  and 
even  of  other  organs  (enteritis,  peritonitis)  which  interfere  with 
the  freedom  of  the  respiratory  act.  If  however  it  is  not  attended 
by  fever  but  associated  with  the  broken  winded  cough,  the  wheez- 
ing respiration,  the  disordered  and  flatulent  state  of  the  bowels, 
the  tumultuous  beating  of  the  heart  against  the  left  side  after  ex- 
ertion, and  the  slight  flow  of  clear,  watery  matter  from  the  nose, 
it  is  pathognomonic.  The  act  of  inspiration  is  quick  and  free,  that 
of  expiration  is  not  uniform  and  continuous  as  in  health,  but  con- 
sists of  two  stages  interrupted  by  a  momentar}'  arrest.  In  the 
first  stage  the  posterior  part  of  the  abdomen  is  slightly  raised  and 
and  it  falls  in  laterally  ;  then  comes  an  almost  imperceptible  pe- 
riod of  inaction,  followed  at  once  by  the  further  lifting  of  the 
flanks  to  complete  the  expulsion  of  air  from  the  lungs.  The  first 
stage  seems  the  natural  collapse  of  the  walls  of  the  chest  and  for- 
ward movement  of  the  diaphragm,  the  second  a  contraction  of  the 
abdominal  muscles  partly  due  to  an  exercise  of  will  to  over- 
come the  obstacle  to  the  expulsion  of  air. 

In  ver}'  bad  or  advanced  cases  these  sj'mptoms  are  more  marked. 
The  inspiration  is  sudden  and  manifested  by  a  rapid  expansion  of 
the  chest,  and  dropping  of  the  belly  previously  supported  by  ac- 
tive contraction  of  the  abdominal  muscles.  The  two  stages  of  the 
expiratory  act  are  quite  distinct.  The  first  is  manifested  by  a 
sudden  falling  in  of  the  walls  of  the  chest  so  that  the  ribs  no  longer 


284  Veterinary  Medicine. 

stand  out  prominently  beyond  their  interspaces  ;  the  abdomen 
equally  rises  inferiorly  and  falls  in  laterally  so  that  a  projecting 
ridge  is  formed  from  the  lower  end  of  the  last  rib  to  the  point  of 
the  hip.  This  is  specially  marked  during  the  period  of  inaction, 
and  this  is  succeeded  by  the  second  effort  quick  and  almost  con- 
vulsive. These  movements  are  so  extensive  that  they  are  con- 
veyed in  a  striking  degree  to  any  vehicle  to  which  the  animal  is 
attached,  especiall)^  if  it  has  only  two  wheels,  and  a  rider  on 
horseback  feels  the  movement  still  more  disagreeably.  When  a 
horse  is  in  this  state  the  alternate  rising  and  falling  of  the  abdom- 
inal organs  imparts  a  synchronous  movement  of  protrusion  and 
and  contraction  to  the  anus  and  in  thin  subjects  a  rising  and  fall- 
ing of  the  muscles  on  each  side  of  the  root  of  the  tail.  The  nos- 
trils too  are  kept  constantly  dilated. 

There  is  a  nasal  discharge,  but  this  is  very  inconsiderable  in  the 
early  stages  of  the  malady.  It  is  a  clear  watery  or  slightly  gray- 
ish albuminous  material  without  any  visible  admixture  of  pus 
globules,  and  on  drying  it  leaves  a  scarcely  perceptible  crust.  At 
first  it  appears  intermittently  and  in  minute  quantities,  but  in  bad 
cases  it  becomes  almost  constant,  and  is  especially  profuse  after 
exercise. 

Abnormal  respiratory  sounds  are  marked  symptoms  in  the 
advanced  stages.  The  wheezing  nois2  of  the  breathing,  especial- 
ly when  that  is  excited  by  exertion,  may  be  heard  at  a  short 
distance  from  the  animal.  The  increased  resonance  on  percussion 
along  the  lower  border  of  the  lung  is  only  heard  when  the  em- 
physema is  extensive.  The  dry  sibilant  or  whistling  rale  heard 
over  the  same  parts  is  equally  a  symptom  of  the  advanced  stages. 
When  there  is  much  discharge  a  moist  rattle  is  often  heard  over 
the  lower  end  of  the  windpipe  or  immediately  behind  the  middle 
of  the  shoulder.  The  overlaying  of  the  anterior  lobe  by  the 
thick,  muscular  shoulder,  and  the  complication  of  results  ob- 
tained at  the  free  border  of  the  lung  by  the  abdominal  noises  and 
resonance  render  these  results  less  conclusive  in  the  earlier  stages 
and  slighter  cases. 

The  application  of  the  hand  to  the  side  of  the  chest  behind  the 
left  elbow  may  detect  a  strong  impulse  of  the  heart  with  each 
beat.  If  the  patient  is  actively  exercised  for  some  time  this  may 
be  felt  on  the  right  side  as  well.  This  symptom  indicates  the 
existence  of  dilatation  of  the  right  cavities  of  the  heart. 


Asthma.     Broken   Wind.     Heaves.     Dyspnoea.  285 

The  symptoms  of  indigestion  are  also  very  manifest.  The 
dung  passed  is  Hke  so  much  chopped  hay  and  oats,  and  does  not 
at  all  resemble  the  faeces  of  a  healthy  horse.  The  abdomen  is 
tumid,  tjnse  and  filled  with  flatus,  which  is  frequently  passed 
per-ano,  and  has  no  doubt  given  rise  to  the  name  of  broken  wind. 
This  expulsion  of  gas  from  the  rectum  usually  takes  place  when- 
ever the  animal  is  excited  to  cough.  When  first  started  on  a 
journey,  the  frequent  passage  of  wind  and  dung  for  the  first  mile 
or  two  is  one  of  the  most  disagreeable  features  of  the  disease. 
When  the  animal  has  thus  emptied  himself  \\^  usually  goes  much 
better  for  the  remainder  of  the  journey. 

Broken-winded  horses  are  always  greedy  feeders,  and  if  they 
get  little  work  they  manage  to  maintain  their  flesh.  But  they 
are  soft  and  flabby,  and  if  put  to  active  work  they  fall  off  rapidly, 
becoming  emaciated  and  hidebound,  a  true  indication  of  their 
impaired  digestion. 

The  symptoms  are  liable  to  occasional  aggravation.  If  the 
stomach  and  bowels  are  overloaded  they  are  invariably  so.  If 
the  patient  is  kept  in  a  hot,  close  stable,  the  same  result  follows. 
Thick,  muggy  w:ather  has  the  same  effect.  After  a  more  than 
usually  severe  day's  work  all  the  symptoms  may  be  intensified, 
and  this  may  continue  for  several  days  or  a  week.  Boule}-  at- 
tributes this  to  an  extensive  rupture  of  air  cells  and  a  sudden 
increase  of  emphysema,  and  the  gradual  subsidence  of  the  symp- 
toms to  the  partial  absorption  of  the  displaced  air  and  the  accom- 
modation of  the  lung  to  its  new  condition. 

Light  and  laxative  diet  on  the  other  hand  alleviates  the  S3'mp- 
toms  and  a  broken-winded  horse  usually  improves  at  grass. 

Cow'se.  The  general  tendency  of  broken  wind  is  to  persistent 
aggravation,  but  by  a  judicious  regimen  many  cases  may  be 
checked  in  their  progress  and  greatly  relieved,  or  even  cured. 

T^'eatment.  We  have  already  seen  that  broken  wind  is  vir- 
tually unknown  on  natural  pastures  where  the  grass  is  short, 
green  and  succulent.  Turning  out  on  such  pastures  will  improve 
or  even  temporarily  cure  mild  cases.  The  same  may  be  said 
of  the  lexative  systems  of  diet.  (See  that  recommended  for 
chronic  bronchitis') .  Feeding  on  dry  grain  only,  wnth  a  very  lim- 
ited .supply  of  water,  will  enable  many  broken-winded  horses  to 
do  ordinary  work  with  comparative  ease  and  comfort.     In  such 


286  Veterinary  Medicine. 

cases,  however,  improvement  is  only  due  to  the  empty  and  un- 
clogged  condition  of  the  digestive  organs  and  the  symptoms 
return  with  all  their  former  intensity  when  the  original  diet  is 
restored.  By  way  of  palliation  much  may  be  secured  by  avoiding 
accidental  causes  of  aggravation.  If  catarrh  or  bronchitis  has 
supervened  it  should  be  treated  in  the  ordinary  way.  If  the 
stomach  and  bowels  are  overloaded  and  costive,  a  small  dose  of 
aloes  and  enemata  will  relieve.  If  the  stable  is  close  a  free  ad- 
mission of  air  will  be  beneficial.  The  temporary  excitement  in 
these  cases  may  be  further  alleviated  by  sedatives,  of  which 
opium  and  digitalis  have  been  mostly  employed.  The  last  agent 
will  sometimes  control  the  breathing  to  such  an  extent  that  the 
horse  may  be  thought  to  have  completely  recovered.  Professor 
Dick  believed  that  he  had  effected  a  cure  in  one  case  by  the  ad- 
ministration at  a  single  dose  of  a  drachm  each  of  camphor,  opium, 
calomel  and  digitalis.  Temporarj^  results  only  can,  however,  be 
expected  from  such  agents,  except  in  the  case  of  an  aggravation 
due  to  a  cause  acting  for  a  limited  time  only,  in  which  case  the 
partial  improvement  may  be  lasting. 

By  adopting  such  measures  to  check  accidental  complications 
and  confining  the  animal  to  a  rigid  system  of  diet  a  broken  winded 
horse  may  be  worked  with  comfort  to  himself  and  his  master. 
The  aliment  should  be  principally  or  exclusively  of  oats,  bran  or 
barley,  though  good  succulent  grass,  turnips,  carrots,  beet,  and 
potatoes  ma}'  be  allowed,  as  may  also  wheat  or  oat  straw  in 
limited  quantity,  but  no  hay  and  above  all  none  prepared  from 
red  clover,  alfalfa,  sainfoin,  or  allied  foreign  plants  and  none  that 
is  musty  or  otherwise  injured  by  keeping.  No  food  nor  water 
must  be  allowed  for  one  or  two  hours  before  going  to  work,  and 
the  pace  must  be  slow  at  first  and  gradually  increased  as  the  horse 
empties  himself,  and  the  breathing  gets  less  embrrassed.  If 
meadow  hay,  straw  or  other  bulky  food  is  allowed  in  small  quan- 
tity this  must  be  after  the  horse  has  returned  from  his  day's  work. 

If  the  food  above  recommended  is  boiled  or  pulped,  and  mixed 
with  some  saccharine  agent  as  molasses  its  restorative  action  is 
enhanced. 

If,  however,  we  add  to  these  hygienic  and  dietetic  measures  a 
prolonged  course  of  arsenic,  the  symptoms  generally  disappear. 
From  five  to  fifteen  grains  of  arsenic  made  into  a  powder  with  a 


Asthma.     Broken   Wind.     Heaves.     Dyspncca.  287 

draclim  of  bicarbonate  of  soda  ina}^  be  given  daily  in  the  food 
until  improvement  is  noticed  or  sj'mptoms  of  the  poisonous  action 
of  the  agent  appear.  When  these  are  manifested  in  loss  of  appe- 
tite, colicy  pains  or  red  and  watery  eyes  the  medicine  must  be 
suspended  and  begun  again  some  days  later  in  smaller  doses. 

The  therapeutic  value  of  arsenic  in  this  case  is  probably  largely 
due  to  its  action  on  the  nervous  system,  which  has  long  been 
recognized.  As  early  as  the  first  century  of  the  Christian  Era, 
Dioscorides,  recommended  its  use  in  asthma  and  in  recent  times 
it  has  acquired  a  considerable  reputation  for  the  treatment  of 
neuralgia.  Another— though  perhaps  an  allied— physiological 
action  of  arsenic  no  doubt  adds  to  its  value  in  this  equine  disorder. 
This  is  its  power  of  retarding  the  waste  of  tissues.  This  property 
it  possesses  in  common  with  tea,  coffee  and  some  other  agents, 
but  to  a  greater  degree.  This  has  led  to  its  extensive  employ- 
ment by  the  peasants  in  L,ower  Austria,  Styria,  and  the  mountains 
separating  Austria  from  Hungary,  who  found  that  it  improved 
their  personal  appearance,  increased  their  weight  and  enabled 
them  to  sustain  greater  exertions  in  climbing  without  fatigue.  It 
was  the  revelations  of  Dr.  Tschudi  concerning  the  Styrian  arsenic 
eaters  that  first  led  Professor  Bouley  to  try  this  agent  in  broken 
wind. 

Examination  of  Broken-winded  Horses.  Though  the 
symptoms  enumerated  above  are  sufficient  to  detect  broken-wind 
in  all  ordinary  cases,  yet  it  may  not  be  time  thrown  away  to  cau- 
tion the  reader  against  pronouncing  it  absent  when  the  more 
prominent  symptoms  are  not  seen.  Unscrupulous  dealers  do  not 
hesitate  to  avail  of  a  variety  of  devices  to  conceal  the  symptoms 
and  make  the  animal  pass  for  a  sound  horse.  Digitalis  and  other 
sedatives  are  so  employed,  but  are  mostly  rejected  because  the)' 
render  the  horse  dull  and  sluggish.  By  some  the  bowels  are  un- 
loaded by  a  dose  of  physic,  the  horse  is  kept  on  a  spare  diet  of 
oats,  beans  and  other  grain,  water  is  withheld,  and  on  the  morn- 
ing of  sale  one  or  two  pounds  of  leaden  shot  or  of  bacon  fat  are 
administered.  The  inconvenience  attendant  on  the  presence  of 
these  agents  in  the  stomach  makes  the  animal  desist  as  much  as 
possible  from  moving  the  abdominal  organs,  and  the  double  lift- 
ing of  the  flank  is  thus  more  or  less  completely  hidden.  With 
the  veterinarian  however  this  measure  like  the  last  defeats  its  own 


288  Ve/erinary  Medicine. 

purpose,  for  such  horses  are  always  intolerably  thirsty  and  if  al- 
lowed to  regale  themselves  at  the  nearest  watering  trough,  the 
charm  is  broken,  the  double  lift  returns  and  with  it  all  the 
symptoms  of  the  malady. 

A  brutal  practice  existed  among  ancient  farriers,  of  making  an 
artificial  opening  into  the  rectum  to  allow  the  exit  of  the  flatus 
upon  which  they  conceived  the  disease  to  depend.  This  was 
effected  either  by  cutting  through  the  .sphinctor  ani  with  a  knife 
or  by  making  a  new  opening  to  one  side  of  it  with  a  red  hot  iron. 
According  to  Ferguson  this  has  been  improved  upon  by  the 
modern  Irish  jockey,  in  the  case  of  broken-winded  mares.  With 
the  knife  an  artificial  communication  is  made  between  the  rectum 
and  the  vagina,  of  sufficient  size  to  insure  that  it  will  remain  open 
and  large  enough  to  allow  pellets  of  dung  to  pass  into  the  vagina. 
The  double  lifting  of  the  flank  forces  the  fseces  through  this  arti- 
ficial opening,  and  to  avoid  the  inconvenience  of  their  presence  in 
the  vagina  the  animal  carefully  refrains  from  this  action.  This 
orifice  further  allows  the  free  escape  of  anj'  gases  generated 
in  the  rectum  and  thus  materially  relieves  the  flatulence.  Fer- 
guson says  he  has  seen  broken-winded  mares  that  have  been 
operated  on  in  this  manner,  that  breathed  so  freely  that  even  pro- 
fessional men  have  failed  to  detect  the  affection. 

In  all  cases  of  broken  wind,  no  matter  how  masked  there  will 
be  manifest,  on  slight  exertion,  a  permanent  dilatation  of  the  no.s- 
trils — i.e.,  alike  in  inspiration  and  expiration, — and  when  any 
such  suspicious  symptom  is  seen  the  horse  .should  be  carefully 
examined,  especially  the  state  of  his  lungs  as  ascertained  by  aus- 
cultation and  percussion,  his  breathing  after  he  has  freely  partaken 
of  water  and  hay,  and,  if  there  is  suspicion  of  drugging,  after  he 
has  stood  over  night  in  a  hot  stable  plentifully  supplied  with  both 
hay  and  water. 

It  should  be  borne  in  mind  that  mares  advanced  in  pregnancy 
often  show  no  double  action  of  the  flank  though  decidedly  broken 
winded. 


POLYPUS  OF  THE  BRONCHIAL  TUBES. 

Like  other  mucous  membranes,  that  covering  the  bronchial 
tubes,  is  hable  to  diseased  growths,  which  may  each  remain  attached 
by  a  broad  base,  and  form  a  morbid  elevation  of  the  surface,  or 
it  may  become  loosened  and  retain  its  connection  with  the  mucous 
membrane  only  by  a  neck  or  pedicle.  An  interesting  case  of  the 
latter  variety  is  recorded  in  the  Edinburgh  Veterinary  Revieiv  for 
January,  1864,  by  Mr.  Parker  of  Birmingham.  It  was  attached 
to  the  wall  of  the  right  bronchus  about  an  inch  below  the  bifur- 
cation of  the  trachea,  and  had  an  ovoid  form  measuring  8^  inches 
in  its  longest  circumference  by  4}^  in  its  shorter.  The  pedicle  was 
lYi  inch  long  and  allowed  the  tumor  to  pass  freely  upward  into 
the  lower  part  of  the  wdndpipe,  threatening  instant  suffocation.  It 
had  a  fibrous  structure  and  was  continous  with  the  interlacing 
bundles  of  yellow-  elastic  tissues  which  cover  the  cartilaginous 
rings  of  the  bronchus. 

From  its  frequent  displacement  upward  the  tumor  gave  rise  to 
paroxysms  of  hurried  and  difficult  breathing  apparently  threaten- 
ing suffocation,  but  when  these  passed  off,  respiration  was  tolera- 
bly tranquil  and  easy.  The  fits  of  dyspnoea  came  on  after  any 
unwonted  excitement,  but  above  all  after  a  cough.  In  such  cases 
the  tumor  had  been  coughed  up  into  the  lower  end  of  the  wind- 
pipe and  until  it  slid  back  into  its  former  position,  the  animal 
seemed  on  the  verj'  verge  of  death.  The  paroxysms  had  appeared 
very  frequently  during  a  period  of  five  months  that  had  elapsed 
since  her  purchase,  increasing  steadily  in  severity  and  finally 
causing  death.  The  lungs  contained  many  small  abscesses  the 
result  doubtless  of  the  frequent  paroxysms  of  dyspnoea. 

Cases  of  this  kind  are  not  usually  amenable  to  treatment,  nev- 
ertheless as  they  are  pretty  certain  to  end  fatally  if  neglected,  it 
would  be  quite  permissible  to  perform  tracheotomy  in  the  lower 
part  of  the  neck  and  attempt  to  snare  the  tumor  with  an  elastic 
wire  passed  through  a  single  or  double  tube.  The  tumor  might 
even  be  seized  by  a  vulsella  and  twisted  off,  provided  it  could  be 
reached. 


19  289 


DISEASES   OF    THE  BRONCHIAI.   AND    MESENTERIC 
GEANDS. 

These  are  the  seat  of  congestions,  neoplasms,  and  parasites,  in- 
cluding pentastoma,  actinomycosis,  tubercle,  glanders,  etc.,  which 
will  be  treated  under  their  respective  headings. 


PARASITES  OF  THE  AIR  PASSAGES,  LUNGS,  AND 
PLEURA. 

Nearly  all  the  domestic  animals  are  subject  to  parasites  of  the 
lower  air  passages.  These  give  rise  to  verminous  bronchitis  in 
cattle,  sheep,  horses,  swine,  goats  and  camels,  to  gapes  in  birds, 
and  to  pulmonary  acariasis  in  fowls.  The  lungs  and  pleura  are 
invaded  by  distomum,  echinococcus,  cysticercus,  aspergillus,  etc. 
(See  parasites). 


290 


DISEASES  OF  THE  HEART  AND  ORGANS 
OF  CIRCULATION. 

Susceptibility  in  different  genera.  Reasons  for  partial  immunity  of  the 
quadruped,  special  and  general  causes  in  quadrupeds,  violent,  forced  work, 
fatty  degeneration,  swallowing  of  pointed  metallic  bodies,  difiBcult  diagno- 
sis in  the  animal.  Position  of  the  heart  in  the  horse,  ox,  sheep,  pig,  car- 
uivora,  birds.  Structure  of  the  heart  as  a  pump.  Results  of  imperfect 
structure  or  action.  Heart-walls.  Table  of  size  of  the  heart.  Capacity. 
Weight.  Pulse  in  each  healthy  genus,  according  to  age,  size,  environment, 
temperament,  proximity  to  parturition.  Morbid  conditions  of  the  pulse, 
frequent,  slow,  quick,  tardy,  full,  strong,  weak,  feeble,  indistinct,  small, 
hard,  wiry,  thready,  oppressed,  leaping  and  receding,  intermittent,  unequal, 
irregular,  anaemic,  venous.  Percussion.  Palpitation.  Ausculation.  Healthy 
sounds.  Morbid  sounds,  in  unusual  place,  force,  intensity,  rythm,  repeti- 
tion of  1st  sound,  of  2nd  sound.  Murmurs,  synchronance  with  given  stages 
of  heart  movement,  their  significance,  pericardial  murmur.  General  symp- 
toms of  heart  disease,  cold  extremities,  passive  congestions,  dropsies  of 
limbs,  etc.,  shortness  of  breath,  venous  pulse,  vertigo,  dulness,  sluggish- 
ness, corpulence. 

The  lower  animals  are  perhaps  less  subject  to  heart  disease  than 
mankind,  but  the  comparative  immunity  generally  assumed  for 
them  is  far  from  being  a  real  one.  The  horizontal  position  of  the 
quadruped  largely  obviates  that  special  tax  upon  the  heait  de- 
manded by  the  erect  position  of  man,  and  especially  by  the  elevated 
place  given  to  his  more  ample  and  vascular  brain.  Animals  too 
are  comparatively  free  from  those  mental  and  moral  influences 
which  so  largely  affect  the  regularity  of  the  circulation  in  the 
human  subject.  But  on  the  other  hand  many  physical  causes  of 
heart  disea.se  affect  the  lower  creation  equally  with  their  lord, 
while  some  undoubtedly  operate  with  special  force  on  the  brute. 
All  animals  are  subject  to  diseases  of  the  heart  as  of  other  internal 
organs,  from  exposure  ;  this  organ  is  occasionally  involved  from 
its  contiguity  with  other  diseased  structures  or  from  interdepend- 
ence of  function  as  we  have  already  seen  in  certain  diseases  of 
the  lungs  (congestion,  brokenwind,  etc.);  the  tendency  to  heart 
disease  frequently  runs  in  a  particular  family  of  animals,  espe- 
cially with  the  rheumatic  constitution,  which  is  transmitted  from 
parent  to  offspring  as  surely  as  the  color  of  the  skin  the  turn   of 

291 


292  Veterinary  Medicine. 

the  horn  or  the  depth  and  spring  of  the  rib.  The  lower  animals 
are  further  subject  to  congenital  malformations  and  imperfections 
and  to  deposits  of  morbid  material  around  the  heart  or  in  its  sub- 
stance so  as  to  impair  its  healthy  action. 

Horses  and  dogs  have  special  predisposing  causes  in  the  violent 
and  prolonged  exertion  to  which  they  are  habitually  exposed. 
The  quiet  sluggish  and  nonexcitable  ox  and  pig  meet  with  dan- 
gers no  less  real  though  of  a  different  kind  in  the  overfeeding 
which  induces  fatty  degeneration  of  the  heart  as  of  other  muscu- 
lar tissues.  The  larger  ruminants  are  further  endangered  by 
their  propensity  to  swallow  needles  and  other  sharp  pointed  bodies 
which  ultimately  reach  and  penetrate  the  heart. 

The  prevalence  of  heart  disease  in  animals  may  be  deduced 
from  the  fact  that  out  of  150  horses,  oxen  and  dogs  dissected  at 
Montfaugon  by  lycblanc  in  1840,  not  less  than  one  twentieth  pre- 
sented cardiac  lesions.  The  supposition  of  an  immunity  of  the 
lower  animals  has  been  largely  due  to  the  heavy  muscular  shoul- 
der of  quadrupeds  which  covers  the  upper  and  anterior  regions  of 
the  heart  shutting  them  out  from  physical  exploration.  In  man 
the  entire  heart  and  connecting  blood  vessels  are  so  open  to  exam- 
ination that  the  physician  can  pronounce  with  the  greatest  accu- 
racy not  only  concerning  the  existence  of  disease,  but  also  its  pre- 
cise locality  and  nature.  In  the  quadruped  no  such  facility  is 
open  to  us,  and  veterinarians  have  too  generally  refused  to  face  the 
difficulty,  preferring  to  ignore  heart  diseases,  or  still  worse  seek- 
ing to  cover  their  ignorance  by  the  assertion  that  such  affections 
rarely  exist.  Now  however  we  not  only  know  that  heart  diseases 
are  much  more  frequent  in  the  lower  animals  than  heretofore  be- 
lieved, but  that  as  a  general  rule  they  are  sufficiently  manifested 
and  recognizable  by  their  distinctive  symptoms. 

Position  and  exposure  of  the  heart.  In  the  horse  the  heart 
has  only  its  apex  and  a  small  portion  of  its  left  ventricle  approach- 
ed to  the  surface  of  the  chest,  at  a  point  where  it  is  felt  to  beat 
behind  the  left  elbow.  The  apex  approaches  the  surface  in  the 
interval  between  the  fifth  and  sixth  ribs  and  close  above  the 
breast  bone.  The  posterior  border  of  the  ventricle  follows  a  nearly 
vertical  line  upwards  from  this  point,  while  the  anterior  border 
has  a  direction  upward  and  forward  crossing  diagonally  over  the 
fifth  rib.     The  part  of  the  ventricle  exposed  extends  about  three 


Diseases  of  the  Heart  and  Organs  of  Circnlation.  293 

inches  upwards  from  the  apex,  and  is  about  two  inches  in  its 
transverse  diameter.  The  great  mass  of  the  organ  is  covered  by 
lung  substance. 

In  the  ox  about  the  same  extent  of  heart  tissue  is  exposed.  In 
sheep  a  portion  about  an  inch  in  height  and  one  and  a  half  inches 
in  breadth  is  left  uncovered  by  lung.  In  the  pig  the  heart  is  ex- 
posed only  in  a  triangular  space  of  about  an  inch  across. 

In  the  carnivora  the  heart  lies  more  directly  in  the  median  line 
of  the  chest.  It  appears  as  if  tilted  forv^ard  so  that  its  apex  is  di- 
rected backward  and  its  base  forward ,  while  the  body  of  the  organ 
lies  directly  over  the  breast  bone.  The  lungs  invest  it  on  both 
sides  preventing  any  approximation  to  the  walls  of  the  chest  later- 
ally, and  it  can  best  be  auscultated  by  applying  the  ear  over  the 
sternum. 

In  birds  the  heart  is  situated  in  the  centre  of  the  chest  and  en- 
veloped by  lung  tissue  so  that  its  exploration  is  about  equally  dif- 
ficult at  all  points. 

The  larger  blood  vessels  at  their  origin  from  the  heart  are  not 
open  to  examination  in  the  lower  animals  except  to  a  limited  ex- 
tent in  the  dog. 

Internal  arrangement  and  structure  of  the  heart..  In  all 
warm  blooded  animals  the  heart  is  composed  of  two  portions,  the 
internal  cavities  of  which  are  perfectly  distinct  from  each  other 
and  contain  blood  in  different  conditions  ;  the  right  portion  hold- 
ing the  impure,  purple  or  venous  blood  which  has  just  circulated 
through  the  body,  and  the  left  portion  being  filled  with  the  bright 
crimson  or  arterial  blood,  which  has  been  aerated  by  circulating 
through  the  lungs.  Each  of  these  portions  is  divided  into  two 
distinct  cavities,  an  ?<!/>/^r  (auricle)  which  receives  the  blood  from 
the  veins,  and  a  lozver  (ventricle)  which  receives  the  blood  from 
the  auricle  and  transmits  it  into  the  arteries.  The  auricle  is  sep- 
arated from  the  ventricle  by  a  transverse  musculo-membranous 
partition  having  a  large  central  orifice  furnished  with  valves  (au- 
riculo-ventricular),  the  free  borders  of  which  are  turned  down- 
ward so  that  they  allow  the  blood  to  flow  freely  downward  from 
the  auricle  but  completely  close  the  orifice  and  prevent  any  reflex 
when  the  ventricle  contracts.  The  great  artery  which  originates 
from  the  base  of  each  ventricle  is  likewise  furnished  with  a  sys- 
tem   of    valves  (semilunar)    having   their    free    borders    turned 


294  Veterinary  Medicine. 

into  the  artery,  so  that  they  allow  blood  to  flow  freely  into 
that  vessel  during  the  contraction  of  the  ventricle,  but  prevent 
any  reflux  into  the  heart  when  the  ventricle  again  dilates. 
The  apparatus  may  be  likened  to  a  force  pump  with  two  systems 
of  valves,  one  to  prevent  the  return  of  any  water  from  the  pump 
into  the  fountain  ;  the  other  to  hinder  any  reflux  from  the  deliv- 
ery pipe  into  the  pump.  Any  interference  with  either  of  these 
valves  entails  a  very  serious  and  usually  a  fatal  disorder  of  func- 
tion. 

These  orifices  differ  considerably  in  size.  Those  between  the 
auricles  and  ventricles  are  considerably  larger  than  those  at  the 
commencements  of  the  great  arteries.  Those  on  the  right  side  of 
the  heart  too  are  greater  than  those  on  the  left.  They  vary  with 
the  form  of  the  heart.  Thus  in  dilatation  of  an  auricle  and  ven- 
tricle on  one  .side  of  the  heart,  the  auriculo-ventricular  opening 
becomes  equally  widened  and  the  valves  remaining  disproportion- 
ately small  the  blood  is  allowed  to  rush  back  into  the  auricle  dur- 
ing ventricular  contraction.  The  left  auriculo-ventricular  open- 
ing has  been  known  to  become  contracted  in  some  very  flat  and 
shallow  chests  ;  the  blood  failing  to  circulate  freely  through  the 
lungs  and  to  reach  the  left  side  of  the  heart  in  a  full  supply  this 
orifice  accommodates  its  size  to  the  amount,  and  may  become  so 
narrowed  that  it  forms  a  serious  obstacle  to  the  blood  flow  and  a 
series  of  morbid  changes  result  following  the  backward  course  of 
the  circulation.  The  auricle  first  becomes  overdistended  and  its 
muscular  walls  increase  in  thickness  and  consistency  ;  the  lungs 
tend  next  to  suffer  from  a  passive  congestion,  and  lastlv  the  right 
side  of  the  heart  becomes  engorged  and  enlarged. 

Any  obstruction  in  the  aorta  which  conveys  the  blood  from  the 
left  side  of  the  heart  equally  leads  to  dilatation  of  its  internal  cav- 
ity and  abnormal  thickness  of  its  walls. 

The  imperfection  of  the  valves  is  one  of  the  most  serious  results 
of  such  changes  in  heart  structure.  The  sounds  by  which  such 
imperfection  may  be  recognized  will  be  presently  noticed,  mean- 
while the  mode  of  testing  this  in  the  heart  of  the  dead  animal  will 
be  referred  to.  If  due  to  structural  changes  in  the  valves  them- 
selves, the  new  deposits,  the  cicatrices,  the  lacerations,  etc. ,  will 
be  visible  to  the  eye.  Though  no  such  disease  changes  are  seen 
the  valves  may   still   manifest  imperfection   by   failing  to  fulfill 


Diseases  of  the  Heart  and  Organs  of  Circidation. 


295 


their  normal  function  when  put  to  the  test.  Water  is  poured  in- 
to one  or  other  of  the  great  arteries  which  arise  from  the  ventri- 
cles, the  vessel  being  held  vertically,  and  if  it  fails  to  descend  into 
the  heart  the  valvular  action  is  perfect.  The  auriculo-ventricular 
valves  may  be  equally  tested  by  filling  the  ventricle  and  observing 
whether  there  is  a  reflux  into  the  auricle. 

The  thickness  of  the  walls  of  the  heart  varies  in  disease. 
The  auricular  walls  are  invariably  thin  and  flaccid  except  as  above 
noted  with  diminution  of  the  auriculo-ventricular  orifice.  The 
walls  of  the  right  and  left  ventricles  differ  in  thickness  in  accord- 
ance with  the  distance  to  which  they  have  respectively  to  propel 
the  blood  and  the  propulsive  effort  demanded.  Thus  the  walls  of 
the  right  ve^itricle  which  is  only  called  upon  to  propel  the  blood 
through  the  lungs  are  only  about  yi  an  inch  in  thickness  and  are 
thinnest  at  their  lower  part.  Those  of  the  left  ventricle  which 
have  to  send  the  blood  to  the  most  distant  parts  of  the,  body  are 
from  I  to  I  ^  inches  except  at  the  lower  part  where  they  form 
the  apex  of  the  heart,  and  are  reduced  to  a  tenuity  resembling  the 
walls  of  the  auricles.  They  are  thickest  at  the  median  part,  and 
diminish  slightly  in  an  upward  or  downward  direction.  The  bulk 
of  these  walls  is  excessively  muscular,  the  fibres  arranged  as  an 
elaborate  double  spiral  and  connected  with  a  layer  of  white  fi- 
brous tissue  placed  in  the  interval  between  the  auricles  and  ven- 
tricles and  surrounding  the  auriculo-ventricular  openings  and  the 
orifices  by  which  the  great  arteries  take  their  origin.  It  is  at  this 
point,  where  the  muscular  fibres  of  the  ventricles  are  connected 
with  the  white  fibrous  rings,  where  rupture  of  the  heart  usually 
takes  place. 

The  following  measurements  may  be  held  to  refer  to  medium 
sized  animals  of  the  different  kinds  mentioned. 


Longitudinal 

Transverse  Diameter  at  the 
Base  of  the  Ventricles. 

Circumfer- 

Inches. 

Antero-Posterior 
Inches. 

Transverse 
Inches. 

Inches. 

Horse 

Ox 

Sheep  

Pig 

Dog 

10 

4 

^\ 

3* 

1\ 

6| 

3 

3f 

3f 

5i 

2 

2 

19I 

7i 

95 

8^ 

296  Veterinary  Medicine. 

The  internal  capacity  of  the  ventricles  is  so  modified  by 
the  amount  oi  post  mortem  contraction  that  it  differs  widely  from 
the  actual  capacity  during  life.  The  left  ventricle  of  the  larger 
domestic  quadrupeds  usually  admits  from  3^  oz.  to  over  5  oz., 
while  the  right  ventricle  whose  walls  are  so  much  thinner  and 
more  lax  will  contain  double  that  amount.  In  the  smaller  ani- 
mals about  a  tenth  of  these  quantities  will  be  admitted. 

The  weight  of  the  heart  too  can  only  be  stated  as  an  average 
or  for  medium  sized  animals.  In  the  horse  it  may  be  from  4)^  lbs. 
to  9  lbs.  ;  in  the  ox  from  3  lbs.  5  oz.  to  4^  lbs.  ;  in  the  sheep 
from  5^  oz.  to  7  oz.  ;  in  the  pig-  from  9)^  oz.  to  14  oz.  ;  and  in 
the  dog-  from  5  oz.  to  7  oz.  This  statement  must  be  understood 
to  apply  to  dogs  approximating  in  size  to  the  .shepherd's. 

Taking  into  account  the  size  of  the  particular  animal  an^^  con- 
siderable deviation  from  these  measurements  and  weights  may  be 
accepted  as  abnormal.  The  ratio  to  the  body  weight  is  about  : — 
horse  and  dog  i  :  100,  ox,  sheep  and  pig  i  :  220.  This  neces- 
sarily varies  with  condition— fat  or  lean. 

The  pulse  offers  valuable  indications  in  disease  of  the  heart. 

The  number  of  the  pulse  in  healthy  full-grown  animals  may  be 
set  down  as  follows  per  minute  : — horse,  36  to  46  ;  ox,  38  to  42 
(with  loaded  paunch  or  in  a  hot  stable  up  to  70)  ;  sheep,  goat 
and  pig  70  to  80;  dog  80  to  100;  cat  120  to  140;  goose  no; 
pigeon  136  ;  chicken  140.  In  old  age  the  pulse  is  less  frequent. 
This  dnninution  may  extend  to  5  beats  per  minute  in  the  larger 
quadrupeds  and  to  20  or  even  30  in  the  .smaller.  Youth  and 
.small  size  again  are  associated  with  a  greater  rapidity  of  the  pulse. 
The  pulse  of  the  foal,  at  birth,  is  about  three  times  that  of  the 
horse  ;  in  the  colt  of  six  months  it  is  double  ;  at  a  year  old  about 
one  and  a  half  times ;  and  at  two  years  old  one  and  a  quarter. 

The  smaller  the  animal,  caeteris paribus ,  the  more  rapid  is  the 
pulse.  Hot  buildings,  exertion,  fear  or  any  other  exciting  cause 
likewise  accelerates  it.  It  is  more  frequent  with  the  nervous 
temperament,  as  for  for  example  in  the  English  race  horse,  or  the 
greyhound,  than  in  the  dull  lymphatic  cart-horse  or  mastiff.  In 
advanced  pregnancy  it  is  increased  in  number.  In  the  cow  and 
mare  it  undergoes  a  monthly  increase  of  four  or  five  beats  per 
minute  after  the  sixth  month.      (Delafond) 

Independently  of  the.se  conditions  a  rapid  pulse  indicates  febrile 


Diseases  of  the  Heart  and  Organs  of  Circulation.  297 

excitement  attendant  on  active  inflammatory  or  other  disease,  or 
a  state  of  weakness  and  debility.  In  this  last  condition  the  heart 
beats  more  frequently  to  secure  a  more  rapid  circulation  in  the 
capillary  blood  vessels,  and  thus  make  up  to  the  craving  tissues 
by  frequency  of  contact,  what  is  wanting  in  the  quantity  and 
quality  of  the  nutritive  fluid.  This  point  cannot  be  too  much 
insisted  upon,  as  the  fatal  doctrine  that  a  rapid  pulse  indicates 
force  of  the  circulation  is  very  misleading  as  to  treatment. 

The  force  and  character  of  the  pulse  differ  in  the  various 
species.  In  the  horse  it  is  full,  moderately  tense  and  elastic. 
In  the  ass  and  mule  it  is  smaller  and  harder,  with  an  inequality 
of  force  in  successive  beats,  and  sometimes  even  a  beat  is  sup- 
pressed or  imperceptible.  In  the  ox  the  pulse  is  full,  soft  and 
regular,  appearing  to  roll  forward  beneath  the  fingers.  In  the 
sheep  and  goat  the  pulse  is  small  but  with  a  peculiar  quick  or 
sharp  beat.  The  pig's  pulse  is  said  to  be  firm  and  hard.  That 
of  the  dog  and  cat  is  firm  and  hard  coming  with  a  sharp  impulse 
against  the  finger.  In  the  dog,  however,  successive  beats  are  not 
always  of  the  same  force  and  an  intermission  or  complete  absence 
of  a  beat  is  by  no  means  an  indication  of  disease  of  the  heart  or 
other  serious  malady.  It  often  attends  the  slightest  excitement 
in  a  perfectly  healthy  animal. 

In  disease  thQ  pulsations  may  become  : — frequent  or  increased 
in  number  ;  slow  or  decreased  in  number  ;  quick  or  striking  with 
a  sharp  impulse  against  the  finger  ;  tardy  or  without  sharpness 
of  stroke  and  as  if  they  rolled  slowly  past  under  the  finger  ;  full 
and  strong  when  the  impulse  is  forcible  and  not  easily  compressed 
b}'-  the  finger  ;  weak,  feeble  or  indistinct  in  the  opposite  con- 
ditions ;  small  when  though  perfectly  distinct  and  forcible  they 
are  wanting  in  fulness  ;  hard,  when  forcible  and  jarring  (this 
is  sometimes  called  wiry  or,  if  smaller,  thready)  ;  soft  when 
though  the  artery  may  be  full  the  beat  is  devoid  of  hardness  and 
easily  compressible  so  as  to  be  unfelt  ;  oppressed  when  with  a 
full  rounded  artery,  the  impulse  is  jerking  though  not  hard  and 
as  if  the  distended  vessels  opposed  the  transmission  of  the  im- 
pulse ;  jerking  and  receding — leaping,  when  with  empty  and 
flaccid  arteries  the  pulse  seems  to  leap  forward  with  each  beat  of 
the  heart — (this  pulsation  may  be  visible  to  the  eye  in  the  caro- 
tids) ;  intermittent  when  after  a  number  of  beats  at  regular  in- 


298  Veterinary  Medicine. 

tervals  there  is  a  complete  pause  extending  over  that  period  of 
time  which  would  have  been  occupied  by  a  full  beat ;  unequal 
when  some  beats  are  strotig  and  others  weak  ;  irregular  when 
without  any  distinct  intermission  for  a  period  equal  to  that  of  a 
single  beat,  the  intervals  between  successive  beats  are  of  varying 
length.  The  pulse  further  has  a  peculiar  thrill  or  tremor  in 
states  of  great  debility  with  deficiency  of  blood  and  imperfect 
filling  of  the  vessels. 

Of  these  the  leaping,  the  intermittent,  the  unequal  and  the 
irregular  pulses  are  of  special  importance  in  their  bearing  on 
heart  diseases. 

The  jerking  and  receding  pulse  is  felt  in  cases  of  imperfection 
of  the  semilunar  valves  at  the  commencement  of  the  great  aorta, 
and  which  allows  blood  propelled  into  the  arteries  by  the  contrac- 
tion of  the  ventricle  to  flow  back  into  the  ventricle  during  its  state 
of  relaxation.  This  pulse  is  met  with  in  other  conditions  as  in 
aneurism  of  the  aorta,  but  if  from  heart  disease  it  is  distinguished 
by  the  presence  of  a  blozving  miirvuir  with  the  second  sound  of 
the  heart. 

The  intermittent  pulse  indicates  functional  derangement  of  the 
heart  but  it  does  not  as  is  generally  believed  betoken  structural 
disease.  It  is  frequently  observed  in  healthy  asses  and  mules, 
and  in  dogs  however  slightly  excited  whether  by  fear  or  J03',  or 
by  the  mere  fact  of  their  being  handled,  it  is  so  common  as  to  be 
almost  the  rule  rather  than  the  exception.  It  may  be  seen  in  a 
healthy  horse  as  the  result  of  excitement.  During  the  early 
stages  of  convalesence  from  inflammatory  affections  of  the  lungs 
in  the  horse  the  pulse  is  often  intermittent.  The  pulsations  are 
at  the  same  time  unequal.  There  is  a  regular  cycle  of  beats  grad- 
ually decreasing  in  force  and  extending  over  a  complete  respira- 
tory act.  The  cycle  commences  with  the  strongest  beat  during  or 
immediately  after  the  act  of  expiration,  and  the  succeeding  four 
or  five  beats  are  less  and  less  forcible  until  the  chest  is  fully  ex- 
panded when  there  is  a  quiescent  interval  corresponding  to  the 
period  of  one  beat.  In  many  such  cases  there  is  no  other  indica- 
tion of  heart  disease  and  the  phenomenon  appears  due  to  the  in- 
terference with  the  circulation  by  the  hepatized  lung,  to  the  im- 
paired nervous  energy  of  the  heart  and  to  its  compression  between 
the  distended  lungs.     A  pulse   simply  intermittent  and  not  asso- 


Diseases  of  the  Heart  and  Organs  of  Cirenlation.  299 

dated  with  any  further  sign  of  heart  disease  does  not  then  possess 
the  significance  generally  attributed  to  it,  but  a  careful  examina- 
tion of  the  heart  should  invaribly  be  made  when  this  functional 
disorder  is  observed.  It  exists  or  ma}^  be  brought  about  by  slight 
excitement  in  the  great  majority  of  heart  diseases. 

In  case  of  intermittent  pulse  it  is  useful  to  ascertain  whether 
there  is  also  an  intermission  of  the  heart's  beat,  since  in  softening 
of  the  heart,  that  organ  may  beat  without  being  able  to  transmit 
the  impulse  along  the  artery. 

A  pulse  at  once  unequal  and  irregular  is  a  much  more  serious 
indication  than  a  merely  intermittent  pulse.  It  is  observed  espec- 
ially in  fatty  degeneration  of  the  muscular  substance,  and  with 
imperfection  of  the  valves  on  the  left  side  of  the  organ,  though  it 
may  be  present  in  other  cardiac  diseases  independent  of  the  exist- 
tence  of  those  lesions. 

In  hypertrophy  of  the  left  ventricle,  the  pulse  is  full  and  strong 
and  the  impulse  appears  prolonged,  because  of  the  greater  length 
of  time  taken  up  by  the  ventricle  in  the  act  of  contraction.  When 
dilatation  coexists  with  hypertrophy  the  impulse  is  still  full  and 
strong,  more  blood  being  transmitted  through  the  vessel ;  but  when 
dilatation  is  combined  with  attennation  of  the  ventricular  walls 
the  impulse  is  soft  and  weak  by  reason  of  the  feebleness  of  the 
contractions. 

The  pulse  at  the  radial  artery  should  be  about  synchronous  with 
the  beat  of  the  heart.  If  retarded  it  may  be  held  to  indicate  the 
existence  on  the  anterior  aorta  or  its  primary  divisions  of  an  aneu- 
rism with  elastic  walls  or  more  probably  an  imperfection  of  the 
aortic  valves,  which  allows  a  regurgitation  of  the  blood  into  the 
heart. 

Venous  pulse.  A  venous  pulse  seen  in  the  lower  end  of  the 
jugular  veins  is  common  in  the  domestic  animals.  In  the  ox  it  is 
quite  compatible  with  health  and  is  only  to  be  judged  by  its  am- 
plitude and  force.  In  other  animals  it  often  coexists  with  conges- 
tion of  the  lungs  which  impedes  the  circulation  through  the  right 
side  of  the  heart  and  leads  to  engorgement  of  the  venous  system. 
In  the  absence  of  this  condition  it  frequently  indicates  an  imper- 
fection of  the  auriculo-ventricular  valves  in  the  right  heart  and  a 
reflux  of  blood  from  the  contracting  ventricle  which  checks  the 
descending  current  in  the  veins. 


300  Vete7'hiary  Medicine. 

Percussion.  In  the  horse  a  dull,  dead  sound  is  emitted  when 
percussion  is  made  over  the  left  side  for  about  four  inches  above 
the  breast  bone  and  in  the  space  corresponding  to  the  lower  ends 
and  the  cartilages  of  prolongation  of  the  fourth,  fifth  and  sixth 
ribs.  In  the  ox  this  dulness  is  less  marked  on  the  level  of  the  sixth 
rib.  The  same  results  can  be  obtained  on  the  right  side  b}^  im- 
parting heavier  blows  to  the  chest  walls  so  as  to  derive  the  sound 
from  the  deeper  parts. 

The  area  of  dulness  is  increased  in  cases  of  hypertrophy  or  in  di- 
latation  of  the  heart  when  the  enlarged  organ  presses  aside  the 
lung  tissue  and  exposes  a  greater  amount  of  its  substance  to  the 
chest  walls.     The  same  result  takes  place  in  hydropericardium. 

The  area  of  dullness  is  diminished  in  cases  of  ruptured  air  cells 
(as  in  "  heaves  ")  when  the  inflated  and  expanded  lung  tissue  en- 
velopes the  heart  more  completely  and  gives  out  its  own  clear 
resonance  where  the  dull  sound   of  the  heart  is  usually  obtained. 

Application  of  the  hand.  Palpation.  In  conditions  of 
health  and  in  quietude  the  hand  applied  on  the  side  of  the  chest, 
close  behind  the  left  elbow  only  just  perceives  the  beat  of  the  heart 
with  each  contraction.  If  the  animal  is  excited  whether  from 
fear,  j 05^  or  physical  suffering  the  heart's  impulse  becomes  more 
powerful  and  by  this  alone  the  state  of  its  function  may  be  very 
satisfactorily  ascertained.  The  impulse  is  strong  in  all  active  fe- 
vers and  extensive  inflammations  of  important  organs,  but  it  is 
especially  marked  in  diseases  of  the  heart  and  lungs.  Irregularity 
in  the  force  of  successive  beats  is  seen  in  various  heart  diseases 
and  debilitated  conditions  are  recognized  in  the  same  way. 

Any  want  of  harmony  between  the  heart's  action  and  the  pulse 
may  be  observed  by  laying  the  right  hand  over  the  region  of  the 
heart  and  applying  the  fingers  of  the  left  on  the  radial  artery.  In 
debility  and  especially  if  from  a  deficiency  of  blood  the  violent  or 
tumultuous  action  of  the  heart  contrasts  strangely  with  the  weak 
jerking  and  compressible  pulse.  The  same  symptoms  are  noticed 
when  the  valves  of  the  heart  close  their  orifices  imperfectly.  In 
convalescence  from  lung  diseases  and  in  certain  diseases  of  the 
heart  a  beat  may  be  felt  by  the  right  hand  for  which  no  corres- 
ponding pulsation  is  felt  in  the  radial  artery  by  the  left. 

When  the  heart  is  hypertrophied  the  impulse  is  stronger  and  is 
associated  with  a  full,  strong,  and  rolling  pulse.     When  it  is  atro- 


Discrscs  of  the  Heart  and  Organs  of  Circnlation.  301 

phied  the  impulse  on  the  chest  and  pulse  beat  are  equally  weak. 
When  water  exists  in  the  pericardium  the  heart  strikes  the  ribs 
with  less  force. 

Sounds  of  the  Heart.  Synchronous  with  each  beat  of  the 
heart  two  distinct  sounds  are  heard,  separated  by  a  short  interval, 
inappreciable  to  most  ears,  and  followed  by  a  period  of  silence. 
These  sounds  are  distinct  alike  in  character  and  duration.  The 
first  sozind  is  dull  and  prolonged  ;  the  second  is  short  and  quick. 
Some  idea  of  these  sounds  w\z.y  be  formed  by  the  pronunciation  of 
the  two  syllables,  lub — tip,  but  an  acquaintance  with  the  sounds 
themselves  is  essential  to  a  correct  conception  of  them.  The  pe- 
riod of  time  occupied  by  the  first  sound  is  double  that  taken  up  by 
the  second  and  in  man  and  the  smaller  quadrupeds  the  subsequent 
period  of  silence  is  of  equal  duration  with  the  second  sound.  Di- 
viding the  time  belonging  to  one  revolution  of  the  heart  into  four 
equal  periods  the  first  two  are  taken  up  by  the  first  sound,  the 
third  by  the  second  sound  and  the  fourth  by  the  interval  of  silence. 
In  the  horse  the  silence  is  more  prolonged,  and  occupies  the  entire 
latter  half  of  the  period  of  a  revolution.  The  relations  stand 
thus  : — the  first  sound  extends  over  two-sixths  of  the  time,  the 
second  sound  over  one-sixth,  and  the  silence  over  three-sixths. 

The_/?r^/  sound,  sychronous  with  the  beat  of  the  heart  against 
the  ribs  corresponds  also  in  point  of  time  with  the  contraction  of 
the  ventricles,  the  closure  and  tension  of  the  auriculo-ventricular 
valves  and  the  rush  of  the  blood  into  the  great  arteries.  The  sec- 
ond sound  corresponds  to  the  reflux  of  blood  in  the  arteries  and 
the  closure  of  the  valves  between  them  and  the  heart.  The  period 
of  silence  represents  the  period  of  rest  during  which  the  heart  is 
being  filled  from  the  veins. 

In  the  horse,  at  rest,  the  first  is  the  only  sound  that  can  be 
distinctly  heard  in  many  cases,  but  during  the  exci.emeut  of  ex- 
ercise, or  in  febrile  conditions  the  second  is  sufficiently  apparent 
and  any  deviation  from  the  natural  character  is  easily  noted. 

These  sounds  are  most  distinct  over  the  lower  end  of  the  fifth 
and  sixth  ribs  on  the  left  side,  but  they  may  be  heard  distinctly 
behind  the  middle  of  the  shoulder  on  either  side  when  the  cor- 
responding limb  is  advanced.  In  birds  the\'  may  be  heard  be- 
neath the  wings  but  above  all  and  most  clearly  over  the  breast- 
bone. 


302  Veterinary  Medicine. 

In  disease  these  sounds  may  be  heard  in  unusual  situations, 
they  may  be  aUered  in  force  duration  or  rythm,  or  they  may  be 
associated  with  other  sounds  or  superseded  by  them. 

The  sounds  may  be  heard  in  new  situations,  in  displacements 
of  the  heart  from  tumors  or  effusions  in  the  chest,  structural 
changes  in  the  lungs,  pleurae,  or  pericardium,  aneurism  of  the 
aorta,  etc.,  etc. 

The  heart  sounds  are  clearly  heard  over  any  part  of  the  chest 
when  the  lung  tissue  intervening  between  that  part  of  the  surface 
and  the  heart  is  solid  (hepatized).  They  are  heard  distinctly  be- 
hind the  median  part  of  the  right  shoulder,  when  liquid  effusion 
into  the  left  pleural  sac  has  displaced  the  heart  to  the  right  ;  and 
when  the  right  cavities  of  the  heart  are  extensively  dilated  as  ex- 
ists so  commonly  in  the  advanced  stages  of  ' '  heaves. ' ' 

The  extent  over  which  the  sounds  may  be  heard  is  increased 
when  the  lung  surrounding  the  heart  is  solidified  (hepatisation, 
splenisation,  etc.),  or  when  liquid  effusion  exists  in  the  chest. 
A  liquid  but  more  especially  a  solid  is  a  better  conductor  of 
sound  than  the  spongy  lung.  Enlargement  (hypertrophy)  of 
the  heart  equally  increa.ses  the  area  of  sound.  The  area  of  sound 
is  lessened  by  atrophy  of  the  heart,  and  by  an  emphysematous 
condition  of  the  lungs  by  which  the  heart  is  more  extensively 
covered  and  further  separated  from  the  walls  of  the  chest. 

The  force  or  intensity  of  the  heart  sounds  is  increased  in  high 
fever,  in  acute  inflammation,  in  increase  of  the  muscular  walls  of 
the  heart  with  enlargement  of  the  internal  cavities,  in  functional 
disturbance  from  fear  or  other  exciting  cause,  and  in  palpitation. 
Often  in  a  weak  and  bloodless  patient  the  heart  sounds  can  be 
clearly  heard  at  several  yards  distance  from  the  animal.  The  zVz- 
tensity  of  the  sounds  is  diminished  in  debility  when  not  associated 
with  palpitation,  in  atrophy  of  the  muscular  substance  of  the 
heart,  in  hypertrophy  of  the  muscular  tissue  of  the  heart 
with  diminution  of  its  internal  cavities,  in  broken  wi?id  when 
the  the  emphysematous  lung  more  completely  envelopes  the 
heart,  and  in  cases  of  extensive  liquid  effusion  into  the  pericar- 
dium which  prevents  the  apex  of  the  heart  from  striking  against 
the  side  of  the  chest. 

The  regular  rythm,  normally  manifested  by  the  two  sounds 
and  the  silence,  may  be  modified  in  the  unequal  irregular  or  in- 


Diseases  of  the  Heart  and  Organs  of  CirculatioJi.  303 

termittent  contractions  of  the  heart.  Kussmaul's  paradoxical 
pulse  is  one  in  which  the  pulse  is  more  frequent  but  less  full  dur- 
ing inspiration  than  expiration.  Seen  in  weak  heart,  during  re- 
covery from  chest  diseases,  in  chronic  pericarditis,  and  when  fi- 
brous bands  encircle  the  root  of  the  aorta.  Bigeminal  and  tri- 
geminal when  two  or  three  beats  follow  each  other  rapidl}^  and 
are  separated  from  the  preceding  and  succeeding  beats  by  longer 
intervals.  This  occurs  in  disease  of  the  mitral  valve,  and  in 
other  weak  states  of  the  heart.  Foetal  heart  rythm  in  which  the 
pause  is  shortened  and  the  two  sounds  of  the  heart  are  almost 
identical,  is  seen  in  the  later  stages  of  fevers,  and  in  extreme 
dilation.  A  curious  aberration  of  rythm  is  the  repetition  of  either 
the  first  or  second  sound.  If  of  the  first  sound  (anapestic  bruit) 
each  beat  will  be  accompanied  by  three  sounds  the  first  two  of  which 
resemble  the  first  sound  of  health.  If  the  second  sound  is  repeated 
(dactylic  bruit,  bruit  de  galop)  the  first  sound  only  will  be  pro- 
longed and  the  last  two  sharp  and  quick.  The  repetition  of  the 
la.st  sound  is  probably  due  to  impaired  nervous  supply  which  allows 
the  completion  of  the  contraction  of  the  ventricle  and  the  closure 
of  the  arterial  (semilunar)  valves  sooner  on  one  side  than  the 
other.  If  due  to  diminution  of  the  arterial  orifice  which  re- 
tarded the  emptying  of  one  of  the  ventricles,  the  first  sound  would 
probably  be  accompanied  by  a  blowing  murmur.  If  the  auriculo- 
ventricular  valves  on  one  side  were  imperfect,  allowing  a  reflux 
into  the  auricle  and  a  more  rapid  emptj'ing  of  the  ventricle  a 
blowing  murmur  would  equally  accompany  the  first  sound.  In 
either  of  these  two  last  mentioned  cases  the  murmur  would  mask 
or  hide  the  first  of  two  doubled  sounds. 

The  repetition  of  the  ist  sound  is  often  due  to  dilitatiou  of  one 
ventricle,  which  in  consequence  is  longer  in  reaching  the  same 
sensation  of  plenitude,  and  in  receiving  the  stimulus  to  contraction. 

Morbid  Sounds.  Murmurs.  The  distinct  and  superadded 
sounds  heard  in  disease  are  usually  designated  murmurs.  They 
originate  in  the  interior  of  the  heart  (endocardial)  or  externally 
to  the  heart  (pericardial).  The  endocardial  sounds  mostly  arise 
from  some  abnormal  conditions  of  the  valves  or  orifices  and  con- 
sist in  a  blowing  or  rushing  noise  which  usualiy  accompanies  or 
displaces  one  of  the  heart  sounds,  though  it  ma)^  precede  or  suc- 
ceed  these.     The  following  table   modified  from   that  of  Bartle 


304  Veterinary  Medici 71  e. 

and   Roger  presents  at  a  glance  the  relations  of  these  different 
sounds  and  their  significance. 

Blowing  or  Hissing  Murmurs. 

Blowing  murmur  ~|  f  Narrowing  of  the  auriculo-ventricular 

before  the  first  \ \      orifice.     Vegetations  or  coagula  on 

sound.  J  (     the  valves. 

f  Strongest  toward  the  base  of  )  Narrowing     of    the 
I      the      heart.       Propagated  j      aortic  opening. 
!      along  the  great  arteries. 
Blowing  murmixr  with  !  ]  Narrowing     of    the 

the  first  sound.  \  Strongest  toward  the  apex  of  |      pulmonary  artery 

I  the  heart.  Not  propaga-  }  or  insufficiency  of 
i  ted  in  the  great  arteries.  |  the  auriculo-ven- 
[  J       tricular  valves. 

„,      .  „  .,,  ■)  Double  rushing  sound  heard  f  Insufficiency  of  the 

Blowmg  murmur  with  I      over  the  grett  arteries,  at         arterial     ^  (semi- 
the  second  sound.        |      each  beat  of  the  heart.         \      lunar)  valves. 

„,       .  r..     1  Double    rushing     sound    \n\  Aneurism      (dilata- 

Blowmg  murmur  after  I      ,,      ^^.-^^  Jf.r,  ^,^  .      ,  [      ,■  .  ,,,^  „^^^, 


.ww...g  xxx^.^^.   C...V..  ,       ^jj^  arteries  with  each  beat  y      tion   of  the  great 
the  second  sound.        J      of  the  heart.  J      aorta.  ^ 

From  the  table  it  will  be  seen  that  each  orifice  in  the  heart  may 
become  the  seat  of  two  perfectly  distinct  and  independent  mur- 
murs ;  one  due  to  constriction  of  the  orifice  in  which  case  the 
sound  is  produced  with  the  onward  progress  of  the  blood  wave  ; 
and  one  due  to  dilatation  of  the  orifice  or  insufficient  closure  of  it 
by  the  valves,  when  the  sound  is  due  to  a  recoil  or  regurgitation 
of  the  blood.  There  is  a  further  sound  due  to  mere  roughness  of 
the  valves  in  cases  of  disease  when  the  sound  will  be  with  the  nor- 
mal current  of  blood,  though  a  second  or  regurgitant  hiss  is  often 
heard  from  the  valves  being  at  the  same  time  insufficient  to  close 
the  orifice.  Another  blowing  murmur  is  usually  heard  over  the 
heart  and  coincident  with  its  first  sound  in  the  bloodless  state 
(anaemia).  This  is  not  necessarily  connected  with  any  diseased 
condition  of  the  heart  itself. 

The  nature  of  these  murmurs  differs  in  special  instances. 
They  may  resemble  the  soft  whisper  of  the  words  zuho  or  azue,  of 
the  double  letter  ss,  or  the  single  letter  r,  according  as  they  are 
soft  or  hard  and  purring. 

The  pericardial  murmur,  caused  by  the  rubbing  of  the  dry 
roughened  surface  of  the  serous  membrane  covering  the  heart  on 
the  correspondingly  dry  rough  surface  of  the  same  membrane,  re- 


Diseases  of  the  Heart  a7id  Organs  of  Circulati07i.  305 

fleeted  on  the  investing  sac,  resembles  that  caused  by  passing  the 
pahn  of  the  one  hand  over  the  other  which  lies  on  the  ear.  It  is 
distinguished  from  the  friction  sound  of  pleurisy  by  its  coinciding 
with  the  movements  of  the  heart  and  not  with  those  of  respiration. 
It  is  usually  heard  alike  during  the  sounds  of  the  heart  and  dur- 
ing the  period  of  silence  or  in  other  words  during  the  movements 
of  contraction  and  dilatation  in  that  organ. 

General  Symptoms  of  Heart  disease.  In  the  acute  inflam- 
matory affections  there  are  the  signs  of  general  constitutional  dis- 
turbance attending  similar  affections  in  other  organs.  The  decis- 
ion as  to  the  true  nature  of  the  disease  must  be  arrived  at  from  the 
special  character  of  the  pulse,  heart  sounds,  etc.  as  already  noticed. 

In  the  chronic  forms  of  the  disease  however  a  particular  class  of 
symptoms  usually  point  towards  the  organ  affected.  In  cattle, 
sheep  and  pigs  raised  only  for  slaughter,  and  as  far  as  possible 
protected  against  active  exertion,  serious  heart  diseases  may  exist 
for  a  length  of  time  without  making  themselves  manifest  by  any 
prominent  symptoms.  Thus  in  cows,  pins  and  other  sharp  pointed 
bodies  swallowed  with  the  food  frequently  make  their  way  to  the 
heart  and  lodge  for  a  length  of  time  in  its  vicinity  without  mate- 
rial derangement  and  when  at  last  the  animal  dies  a  sudden  death 
they  are  found  transfixing  the  walls  of  that  organ.  In  the  horse 
or  other  animal  subjected  to  exertion  the  symptoms  are  usually 
very  patent. 

When  the  heart  is  enlarged  the  pulse  strong  and  the  circula- 
tion full  and  free,  apoplexies  or  hemorrhages  especially  on  the 
brain  or  other  soft  organs  where  the  resistance  is  least,  are  liable 
to  occur.  When  on  the  other  hand  the  circulation  is  weak  from 
atrophy  or  fatty  degeneration  of  the  heart,  or  from  insufficiency 
of  the  valves  there  is  a  tendency  to  coldness  of  the  extremities, 
and  to  passive  congestions  with  their  consequences  : — serous  effu- 
sions, dropsies,  and  difficult  breathing.  The  imperfect  supply  of 
blood  to  the  muscles  of  the  extremities  sometimes  brings  about  an 
unsteadiness  of  gait  in  the  hind  limbs  when  the  animal  is  trotted 
for  a  short  distance  and  sometimes  cramps  supervene. 

Continued  coldness  of  the  limbs,  and  a  filling  or  thickening  first 
of  the  hind  limbs  then  of  the  fore  and  lastly  of  the  chest  and  belly 
and  of  the  skin  beneath  their  dependent  parts  are  useful  indica- 
tions. 

20 


3o6  Veterinary  Medicine. 

Shortness  of  breath  and  inabihty  to  proceed  when  trotted  or 
galloped  on  hard  ground  or  when  walked  up  hill,  the  animal  being 
in  fair  condition,  without  fever  or  cough,  but  subject  to  cold  ex- 
tremities and  a  venous  pulse  in  the  jugulars,  almost  certainl}'  in- 
dicates insufficiency  of  the  auriculo-ventricular  valves  on  the  right 
side  of  the  heart. 

Vertigo  megrims  or  giddiness  may  be  caused  by  heart  disease 
The  horse  without  having  sustained  any  pressure  on  the  veins  of 
the  neck  by  the  collar,  and  having  had  no  previous  symptom  of 
brain  disease  suddenly  reels  in  harness  and  perhaps  falls.  There 
are  the  cold  and  engorged  limbs  or  a  tendency  to  their  engorge- 
ment as  in  the  former  case.  The  attacks  recur,  when  the  horse 
is  put  to  the  same  exertion,  and  he  proves  utterly  worthless.  In 
such  cases  a  careful  examination  of  the  pulse  and  heart  sounds 
will  complete  the  chain  of  evidence. 

An  almost  constant  feature  of  chronic  heart  disease  is  a  condi- 
tion of  dulness,  sluggishness,  and  in  many  cases,  curiously  enough, 
a  tendency  to  lay  on  fat,  so  that  although  the  patient  is  unfit  to 
work,  he  appears  to  enjoy  excellent  general  health  to  which  a  pe- 
riod is  only  put  by  sudden  death. 

Affections  of  the  heart  are  primarily  divisible  into  functional 
and  strjtcticral  disorders. 


PALPITATIONS. 

Convulsive  contraction  of  the  heart,  functional  or  structural  diagnostic 
features  of  these.  Significance  of  the  functional  disorder,  genera  most  lia- 
ble.    Treatment,  quiet,  heart  tonic,  digitalis,  correct  other  disorders. 

These  consist  in  a  sudden  violent  and  convulsive  beating  of  the 
heart,  not  connected  with  any  appreciable  structural  disease.  They 
differ  chiefly  from  the  palpitations  of  organic  disease  of  the  heart 
in  the  absence  of  any  apparent  local  change  to  account  for  their 
occurrence.  The  following  table  from  Bellingham  furnishes  a 
number  of  criteria  equally  valuable  in  the  lower  animals  as  in 
man. 

PALPITATION     DEPENDENT     ON     OR-     PALPITATION    INDEPENDENT   OF   OR- 
GANIC DISEASE  OF  THE  HEART.         !        GANIC  DISEASE  OF  THE  HEART. 

1.  Palpitation  usually  comes  on  i.  Palpitation  usually  sets  in  sud- 
slowly  and  gradually.  denly. 

2.  Palpitation     constant,      though  |      2.   Palpitation    not   constant,  hav- 
more  marked  at  one  period  than  at ;  ing  perfect  intermissions, 
another.  j 

3.  Impulse  of  the  heart  usually  j  3.  Impulse  neither  heaving  nor 
stronger  than  natural,  sometimes  re-  prolonged  ;  often  abrupt  knocking 
markably     increased     heaving    and    and  circumscribed,  and  accompanied 


prolonged  ;    at  others  irregular   and 
unequal. 


4.  Palpitation  often  accompanied 
by  the  auscultatory  signs  of  diseased 
valves. 

5.  Rythm  of  the  heart  regular, 
irregular,  or  intermittent;  its  action 
not  necessarily  quickened. 


by  a  fluttering  sensation  (visible 
jerking  or  lifting)  in  the  precordial 
region  or  epigastrium  (flank  and  abr 
domen). 

4.  Auscultatory  signs  of  diseased' 
valves  absent ;  bellows  sound  often 
present  in  the  large  arteries  and  ai 
continuous  murmur  in  the  veins. 

5.  Rythm  of  heart  usually  regu- 
lar, sometimes  intermittent;  its 
action  generally  more  rapid  than, 
natural. 

6.  Mucous   membranes   often  red-  ;      6.  Mucous    membranes    generally 
dened    and    congested  ;     dropsy    of  pale  ;  dropsy  of  hind  limbs  rare, 
hind  limbs  common. 

7.  Palpitation  increased  by  exer-  7.  Palpitation  increased  by  close 
else,  by  stimulants  and  tonics,  etc. ;  confinement  ;  by  local  and  general 
relieved  by  rest  and  frequently  also  bleedings,  etc.;  relieved  by  moderate 
by  local  and  general  bleeding  and  an  :  exercise  and  by  stimulants  and 
antiphlogistic  regimen.  tonics,  particularly  the  preparations 

I  of  iron. 


3o8  Veterinary  Medicine. 

Palpitations  in  the  lower  animals  not  dependent  on  any  struc- 
tural disease  of  the  heart  are  usually  due  to  some  violent  mental 
emotion,  such  as  fear  or  joy.  The  author  once  possessed  a  fast 
and  clever  cob,  having  no  sign  of  organic  disease,  and  equal  to 
the  severest  work  on  the  road  without  showing  signs  of  exhaus- 
tion, but  which  nevertheless  was  affected  by  palpitation  when 
threatened  with  a  cane  in  his  stall,  or  if  he  had  been  guilty  of  some 
wilful  misdemeanor  for  which  he  dreaded  punishment.  In  such 
cases  the  heart's  action  was  accelerated  and  the  beating  could  be 
heard  loudly  for  a  distance  of  several  yards.  They  are  especially 
common  in  dogs  under  strong  mental  emotion  (joy,  fear),  and  in 
dogs  and  pigs  suffering  from  digestive  disorder  (worms)  or  chest 
diseases. 

Percivall  collects  a  series  of  cases  from  the  I  \'tcrinarian  under 
the  head  of  Spasm  of  the  Diaphragm,  a  diagnosis  originating  in 
the  jerking  movement  of  the  flank,  a  symptom  which,  as  is  shown 
in  the  above  table,  is  common  to  man  as  well.  I^eblanc  equally 
collects  cases  from  the  French  veterinary  journals  and  acknowl- 
edges their  true  character.  One  of  these  observed  by  Coulbeaux 
is  thus  described  :  "The  respiratory  movements  are  interrupted 
by  a  violent  lifting  of  the  flanks,  confined  to  the  upper  part, 
and  so  intense  as  to  be  appreciated  by  the  hand  as  well  as  the 
eye.  The  lifting  of  the  flank  which  is  limited  to  a  few  square 
inches  of  surface  precisely  in  the  hollow  of  this  region,  is  per- 
fectly isochronous  with  the  beats  of  the  heart,  which  cannot  be 
appreciated  but  by  the  ear. ' ' 

A  case  reported  by  Levrat  at  greater  length  may  also  be  given. 
The  subject  a  mare,  fifteen  years  old,  and  kept  for  hire,  was  at- 
tacked without  any  known  cause.  ' '  There  was  a  jerking  of  the 
whole  body  produced  by  the  extraordinary  force  of  the  beats 
of  the  heart  which  struck  violently  against  the  back  towards 
the  upper  ends  of  the  first  asternal  ribs  on  the  left  side.  The 
shock  is  very  distinct  and  does  not  appear  to  be  due  to  any 
tumor  interposed  between  the  heart  and  the  ribs  ;  its  force  is 
such  that  it  causes  a  movement  of  the  whole  body,  which  can 
be  seen  at  a  great  distance.  The  beats  of  the  heart  very  regu- 
lar, numbering  fifty  per  minute,  were  heterochronous  with  the 
pulsations  of  the  submaxillary  artery,  which  are  of  the  same 
number."       (The   pulsation    was   evidently   retarded).       "The 


Palpitations.  309 

pulse  was  soft  and  regular.  The  breathing  was  peculiar.  On 
approaching  the  ear  to  the  nostrils  the  animal  is  heard  to  make 
three  successiv'e  inspirations  which  coincide  with  the  beats  of 
the  heart ;  each  of  these  inspirations  is  followed  by  an  expira- 
tion so  short  and  feeble  that  the  expired  air  can  not  be  felt ;  the 
fourth  is  followed  by  full  expiration  sustained  during  three 
beats  of  the  heart."  This  form  of  respiration  was  continued 
without  intermission  for  an  entire  day. 

In  three  ca.ses  observed  at  the  Lyons  Veterinary  School  the 
disease  continued  for  eight  days.  In  all  these  and  twenty  more 
observed  by  Leblanc,  the  patients  invariably  recovered.  The 
steady  persistence  of  the  disease  for  .several  days  and  the  subse- 
quent complete  recovery  under  the  unaided  action  of  digitalis 
would  .seem  to  warrant  the  conclusion  that  such  cases  were  really 
accompaniments  of  structural  diseases  of  the  heart  and  not  mere 
functional  disorders.  Even  inflammation  of  the  lining  membrane 
of  the  heart  often  exists  without  any  obvious  fever  or  other 
manifest  symptom  of  illness,  and  in  the  dissecting  rooms  of 
medical  schools  nothing  is  more  common  than  to  find  traces  of 
pre-exi.sting  heart  di.sease  in  patients  whose  whole  life  had  been 
pas.sed  without  the  suspicion  of  such  a  malady. 

A  number  of  such  cases  observed  in  England  and  on  the  Euro- 
pean Continent  are  adduced  to  prove  .spasm  of  the  diaphragm  or 
of  the  abdominal  muscles,  (Delafond),  and  great  importance  is 
attached  to  the  fact  that  the  convulsive  movements  of  the  abdo- 
men and  loins  are  heterochronous  with  the  beats  of  the  heart. 
This  lack  of  exact  coincidence  however  does  not  seem  to  amount 
to  more  than  a  perceptible  delay  after  the  heart  beat,  ju.st  as  the 
maxillary  pulsation  is  delayed  in  case  of  aneurism  of  the  aorta. 
This  has  been  my  own  experience  with  such  cases.  The  flank 
movements  have  been  equal  in  number  to  the  heart  beats  or  have 
corresponded  to  certain  beats  in  the  heart  C3xle,  and  have  been 
perceptibly  retarded  in  accordance  with  the  necessity  for  time  for 
the  transmission  of  the  blood  wave  along  the  po.sterior  aorta  and 
the  development  of  the  reflex  action  which  set  the  phrenic  and  ab- 
dominal muscles  in  motion.  We  must  of  course  accept  the  con- 
vulsive action  of  the  phrenic  and  abdominal  muscles,  only  it  would 
seem  that  each  such  movement  has  its  starting  point  in  the  con- 
traction of  the  heart.     In  cases  that  show  no  relation  in  number 


3IO  Veteri7iary  Medicine. 

nor  succession  with  the  heart  beats,  we  can  freely  acknowledge  a 
neurosis  starting  at  a  point  different  from  the  heart,  but  in  all  ex- 
amples which  are  manifestly  connected  with  heart  movements,  and 
readily  curable  by  the  heart-tonic  digitalis,  the  recognition  of  the 
cardiac  derangement  as  an  initial  factor  is  sound  alike  in  pathol- 
ogy and  practice. 

Nervous  and  purely  functional  palpitations  are  probably  con- 
fined to  cases  in  which  they  are  manifested  at  intervals  appearing 
under  the  influence  of  some  transient  excitement,  and  continuing 
only  for  a  few  minutes  at  a  time. 

In  the  ansemic  or  bloodless  condition  the  palpitation  of  weak- 
ness is  often  observed  under  the  slightest  exciting  cause.  It  is 
then  associated  with  a  pallid  state  of  the  visible  mucous  mem- 
branes, a  weak,  trickling  pulse  and  a  blowing  murmur  in  the 
larger  veins. 

Palpitations  are  much  more  frequent  in  pigs  and  dogs  than  in 
horses. 

Treat7nent.  Quietness  and  avoidance  of  all  excitement  are  first 
to  be  secured,  then  the  action  of  the  heart  is  to  be  calmed  and  reg- 
ulated by  the  use  of  digitalis.  To  the  horse  15  to  30  grains  of 
the  powered  leaves  may  be  given  thrice  daily,  and  to  the  dog  from 
two  to  four  grains  at  equal  intervals.  When  the  disease  is  associ- 
ated with  anaemia  this  agent  may  still  be  used  in  combination  with 
the  various  tonic  remedies  recommended,  but  in  the  smallest 
doses  only  as  the  heart  is  usually  morbidly  sensitive  to  external 
influences.  Chloral  hydrate  has  been  used  with  success.  Brom- 
ides, valerian,  and  belladonna  may  be  tried  in  obstinate  cases. 
Any  other  deviation  from  a  healthy  condition  must  be  noted  and 
corrected,  especially  any  disordered  condition  of  the  stomach  or 
bowels. 


ANGINA  PECTORIS.     BREAST  PANG. 

W.  Williams  describes  a  case  of  illness  in  the  horse  to  which  he 
gives  this  name.  When  standing  idle  he  had  twitchings  of  the 
pectoral  muscles,  and  when  exercised  these  and  adjacent  muscles 
became  violently  convulsed,  the  left  fore  limb  being  alternately 
fixed  by  spasm,  and  paralyzed  so  that  it  was  useless  and  the  ani- 
mal fell  if  compelled  to  move.  There  was  "  venous  pulse,  great 
irregularity  of  the  heart's  action,  a  loud  cooing  or  blowing  sound 
and  strong  impulse  indicative  of  hypertrophy  and  a  want  of  cor- 
respondence between  the  cardiac  energy  and  feeble  pulse.  "  It 
was  unfortunate  that  the  murmur  was  not  associated  by  the  ob- 
server with  a  particular  heart  sound,  and  with  the  right  or  left 
side  of  the  heart,  and  that  hypertrophy  was  not  diagnosed  by 
percussion,  since  the  case  can  be  of  little  value  as  it  stands. 

Breast  pang  is  usually  associated  with  some  disease  of  the  heart  : 
obstruction  (usually  calcification)  of  the  coronary  arteries,  insuf- 
ficiency of  the  aortic  valves,  calcareous  degeneration  of  the  aorta, 
aortic  aneurism,  or  fatty  degeneration  of  the  heart.  Eoomis, 
basing  his  view  on  dissections  made  by  himself  and  others,  re- 
solves all  of  these  into  concurrent  ischsemia  of  the  heart,  the  cir- 
culation in  the  coronary  arteries  being  seriously  interfered  with. 
' '  That  the  sudden  withdrawal  of  a  supply  of  blood  to  a  part  may 
occasion  neuralgia  is  shown  by  the  intense  pain  in  the  limb  which 
directly  follows  embolism  of  the  femoral  artery.  Moreover  gen- 
eral anaemia,  as  is  well  known,  favors  the  recurrence  of  neuralgia 
in  various  situations.  "  Inability  of  the  heart  to  propel  the  blood 
is  to  be  explained  in  the  same  way. 

The  difficulty  of  endorsing  Williams'  diagnosis  lies  in  the  fact 
that  the  disease,  so  far  as  it  is  a  distinct  disease,  is  functional  and 
manifested  by  pain,  the  nature  of  which  can  only  be  inferred  in 
the  case  of  the  lower  animals  (not  by  spasms  of  the  pectoral  mus- 
cles), and  that  hypertrophy  of  the  heart  is  not  likely  to  be  present 
in  case  of  insufficiency  of  blood  supply  to  its  walls. 

In  true  angina  pectoris  of  the  horse,  treatment  is  useless.  Ab- 
solute rest  is  a  prime  requisite,  and  anodynes,  stimulants,  heart 
tonics,  and  nerve  tonics  are  indicated.  But  the  horse  at  rest 
with  no  prospect  of  final  recovery  is  simply  a  source  of  expense. 

311 


FUNCTIONAL    IRREGUI.ARITY    IN    THE    RYTHM    OF 
THE  HEART. 

Associated  or  not  with  palpitation,  irregularity  in  the  force  or 
frequency  of  the  heart-beats  is  sometimes  met  with  at  intervals 
or  independently  of  any  further  indication  of  structural  disease. 
Particularly  in  the  greyhound  and  certain  other  breeds  of  dogs 
the  temporary  occurrence  of  intermitting  action  of  the  heart  is  a 
frequent  though  a  very  transient  condition.  It  may  be  excited  by 
some  emotion  or  excitement  such  as  the  attentions  of  the  owner, 
or  the  straining  anxiety  in  the  immediate  anticipation  of  the  chase. 
Here  again  digitalis  is  pronounced  the  great  panacea  though  it 
need  not  be  resorted  to  unless  the  habit  interferes  with  the  use- 
fulness of  the  animal.  If  in  any  degree  dependent  on  weakness, 
that  must  be  counteracted  by  a  systematic  tonic  treatment. 


312 


CONGENITAL    MAI.FORMATIONS  AND  DISPLACE- 
MENTS OF  THE  HEART. 

Ectopia  Cordis.  Cyanosis,  pervious  foramen  ovale.  Symptoms,  blue 
mucosjE,  coldness,  staring  coat,  unlhriftiness.  Unequal  to  exertion,  palpi- 
tations, murmur  before  the  first  heart  sound.  Obstructed  circulation  in  the 
lungs  as  a  cause  of  cyanosis,  cyanosis  as  a  cause  of  lung  disease. 

These  have  been  much  le.ss  frequently  observed  in  the  lower 
animals  than  in  man.  The  anomalies  observed  in  mammals  in- 
clude the  following  :  The  displacement  of  the  heart  to  the  right 
side  of  the  chest ;  di.splacenient  entirely  out  of  the  chest  (ectopia 
cordis);  permanent  communication  between  the  right  and  left 
auricles  (^cyanosis);  entire  ab.sence  of  heart;  two  hearts;  one 
common  ventricle  communicating  with  two  auricles  as  in  reptiles  ; 
three  ventricles  ;  only  one  auricle  ;  absence  of  one  or  several 
valves  ;  absence  of  the  pericardium  ;  variations  in  the  mode  of 
connection  of  the  heart  and  large  vessels,  etc. 

Displacements  of  the  heart  have  been  especially  studied  by 
Hering  on  calves.  The  breast  bone  remained  as  originally  devel- 
oped in  two  lateral  halves,  and  the  heart  remained  outside  con- 
nected with  the  interior  of  the  chest  only  by  its  large  vessels. 
The  heart  thus  exposed  and  covered  only  by  its  investing  mem- 
brane (pericardium)  afforded  an  excellent  opportunity  to  study 
its  action,  of  which  Hering  freely  availed  himself.  Animals 
affected  in  this  way  survived  their  birth  but  a  very  short  time. 
An  approach  to  this  condition  was  thirty  years  ago  made  familiar 
to  the  medical  world  in  the  person  of  M.  Gouz,  a  German  me- 
chanic, the  movements  of  whose  heart  could  be  easily  watched 
through  a  fissure  in  the  breast  bone. 

Permanent  communication  between  the  two  auricles. 
Pervious  foramen  ovale.  Cyanosis.  Previous  to  birth  there 
is  an  opening  between  the  right  and  left  auricle,  allowing  the 
blood  to  flow  from  the  former  into  the  latter  in  place  of  ,as  in  after 
life,  descending  into  the  right  ventricle  and  thence  circulating 
through  the  lungs.  iVt  birth  this  is  contracted,  and  in  a  few  days 
is  completely  closed  in  accordance  with  the  new  life,  which  de- 
mands that  all  blood  must  circulate  through  the  lungs  in  order  to 

313 


314  Veterinary  Medicine. 

its  aeration.  Sometimes  this  fails  to  be  effected,  and  venous  blood 
from  the  right  side  of  the  heart  continues  to  mix  with  arterial  in 
the  left,  deteriorating  it  in  quality  and  unfitting  it  for  nutrition, 
secretion,  calorification,  and  other  essential  processes.  The  semi- 
venous  blood  circulating  in  the  arteries  gives  a  bluish  hue  to  the 
visible  mucous  membrane,  hence  the  name  of  the  blite  disease. 
This  blood  is  unfit  for  sustaining  the  vital  changes  essential  to  the 
production  of  animal  heat,  so  that  the  animal  suffers  from  cold- 
ness of  the  surface  and  extremities,  staring  coat  and  general  un- 
thrifty appearance.  Such  subjects  grow  badlv,  and  refuse  to  lay 
on  flesh,  but  are  said  to  arrive  at  maturity  in  some  instances  and 
to  have  their  imperfection  recognized  only  because  of  the  short 
breathing,  and  irregular  heart's  action  when  subjected  to  exer- 
tion. A  heart  murmur  preceding  the  fir.st  sound  of  health  is 
usually  present,  as  in  anaemia. 

Drs.  Abernethy  and  Wardrop  draw  attention  to  the  frequency 
of  previous  forame7i  ovale  in  the  human  subject  in  connection 
with  pulmonary  consumption,  and  opine  that  it  is  reopened  as  a 
consequence  of  this  disease.  The  coincidence  has  not  been  ob- 
served in  the  lower  animals,  though  if  it  were  found  to  exist  the 
question  would  arise  whether  the  deterioration  of  the  blood  and 
general  health  in  open  foramen  ovale  did  not  also  favor  the  de- 
posit of  tubercle  in  the  lungs.  When  from  deficient  ventilation 
the  atmosphere  and  blood  become  impregnated  with  carbonic  di- 
oxide the  production  of  tubercle  in  man  or  in  animals  is  corre- 
spondingly frequent. 

The  subjects  of  previous  foramen  ovale  die  5'oung  or  prove 
worthless  when  they  arrive  at  maturity.  Nothing  can  be  done  to 
ameliorate  the  condition. 


HYPERTROPHY  OF  THE  HEART. 

Simple,  eccentric,  concentric.  Ventricles  chiefly  affected.  Causes,  in- 
creased functional  activity,  from  obstruction  to  the  circulation,  or  con- 
tinued extra  exertion.  Right  ventricular  hypertrophy-obstruction  in  the 
pulmonary  circulation  ;  left  ventricular  hypertrophy-obstruction  in  the 
systemic.  Auricular  hypertrophy-insufficiency  of  the  anriculo- ventricular 
valves.  Pericarditis  as  a  cause.  Abnormal  weights.  Symptoms,  beats 
more  forcible  and  prolonged,  ist  sound  low,  prolonged,  2nd  sound  clear, 
often  doubled,  increased  dulness  on  percussion,  diagnostic  signs  of  hyper- 
trophy, dilatation  and  a  combination  of  the  two.  Simple  hypertrophy 
rarely  dangerous,  with  dilatation  grave,  threatens  congestions  and  apoplex- 
ies.    Treatment,  rest,  laxatives,  sedatives,  in  irregular  heart  action  digitalis, 


An  enlargement  of  the  heart  from  increase  of  its  muscular  sub- 
stance is  by  no  means  uncommon  in  the  horse.  It  may  exist 
without  any  change  in  the  capacity  of  the  cavities  of  the  heart 
(simple  hypertrophy)  or  it  may  be  associated  with  dilatation  of 
one  or  more  of  these  cavities  (hypertrophy  with  dilatation  ; — ex- 
centric  hypertrophy).  A  third  variety  has  been  described  in 
which  the  capacity  of  the  cavities  is  decreased  but  Cruveilhier 
and  Budd  have  satisfactorily  shown  the  nonexistence  of  this  con- 
dition except  as  a  congenital  deformity. 

It  is  in  the  ventricles  that  the  increase  is  chiefly  observed,  the 
rea.son  of  which  is  to  be  found  in  the  causes  of  the  malady.  These 
usually  consist  in  some  obstruction  to  the  circulation  such  as 
chronic  congestions  in  the  lungs  or  elsewhere,  rupture  of  air  cells 
in  the  lungs,  tuberculous  and  other  abnormal  dcpo.sits  in  the  chest 
and  elsewhere,  tumors  which  by  their  position  interfere  with  the 
circulation  through  the  larger  vessels,  and  the  like.  Where  by 
some  such  cause  the  blood  is  impeded  in  its  outward  course,  one 
or  both  ventricles  are  called  upon  to  contract  more  vigorously  to 
force  a  sufficient  amount  of  blood  onward  and  in  accordance  with 
the  inherent  adaptability  of  the  animal  economy,  there  takes  place 
an  increase  of  the  muscular  walls  of  the  ventricle  proportionate 
to  the  required  energy  of  the  contractions.  The  condition  then 
is  e.s.sentially  due  to  a  more  active  nutrition  and  growth  of  the 
muscular  substance  and   finds  its  exact  parallels  in  the  well-de- 

315 


3i6  Veterinary  Medicine. 

veloped  legs  of  the  ballet  dancer  or  the  brawny  arm  of  the 
blacksmith.  All  alike  occur  in  accordance  with  a  general  law 
that  whenever  there  is  habitually  demanded  of  any  organ  an  un- 
usual activity  of  function,  which  stimulates  without  exhausting 
its  power,  nature  adds  to  the  active  element  of  such  organ  till  the 
required  labor  can  be  accomplished  without  the  overwork  of  any 
particular  part. 

Keeping  this  in  view  we  can  easily  explain  the  increase  of  one 
part  of  the  heart  without  immediate  implication  of  another.  The 
ventricles  are  more  commonly  enlarged  than  the  auricles  because 
upon  them  devolves  the  work  of  overcoming  the  obstruction, 
whether  this  exists  in  the  lungs  or  the  system  at  large.  The 
auricles  fulfill  little  more  than  a  passive  function  in  receiving  the 
blood  from  the  veins  during  the  contraction  of  the  ventricles  and 
allowing  it  to  pass  down  into  these  when  their  relaxation  takes 
place.  The  closure  of  the  auriculo-ventricular  valves  during  the 
ventricular  contraction  protects  the  auricles  from  the  internal  ten- 
sion to  which  the  lower  part  of  the  heart  is  subjected  and  thus 
all  tendency  to  increase  is  obviated. 

The  hypertrophied  part  corresponds  to  the  locality  of  the  ob- 
struction. If  it  exists  in  the  lungs  (heaves,  consumption,  hepa- 
tisation,  chronic  bronchitis),  pulmonary  artery,  its  valves  at  its 
origin  from  the  heart,  or  if  it  consists  in  contraction  of  that  ori- 
fice, the  enlargement  takes  place  primarily  in  the  right  ventricle, 
the  right  auricle  remaining  unchanged  so  long  as  the  auriculo- 
ventricular  valves  act  perfectly.  The  ventricle,  however,  tends 
to  dilate  as  well  as  enlarge  in  thickness  of  walls,  and  as  soon  as 
this  dilatation  has  proceeded  so  far  as  to  widen  the  orifice  between 
the  auricle  and  ventricle  and  render  its  valves  insufficient,  the 
auricle  also  begins  to  dilate  and  its  walls  often  increase  in  thick- 
ness. But  the  vicious  chain  does  not  end  here.  Should  the 
animal  survive  and  the  original  obstruction  persist,  the  veins 
throughout  the  system  become  habitually  congested  because  of 
the  reflux  of  blood  from  the  right  auricle  and  ventricle,  dropsies 
appear  in  different  parts,  the  congestion  of  the  veins  is  continued 
through  the  capillary  blood-vessels  to  the  arteries,  the  difficulty 
of  propelling  the  blood  comes  to  be  experienced  by  the  left  ven- 
tricle and  a  corresponding  series  of  morbid  changes  taking  place 
on  that  side,   as  have  already   ensued   on   the  right,  the  vicious 


Hypertrophy  of  the  Heart.  317 

circle  is  soon  completed,  and  the  entire  organ  becomes  diseased, 
each  constituent  part  of  the  organ  operating  injuriously  on  that 
which  preceded  it  in  the  track  of  the  circulation,  and  ever}^  new 
change  forming  but  a  stepping  stone  to  a  more  dangerous  modifi- 
cation. 

On  the  other  hand  the  obstruction  may  exist  in  the  general  cir- 
culation, on  the  course  of  the  aorta,  or  its  branches,  in  its  valves 
at  its  origin  from  the  heart,  or  in  the  narrowing  of  its  orifice. 
Then  the  increase  takes  place  first  in  the  left  ventricle,  is  propa- 
gated to  the  left  auricle,  leads  to  congestion  of  the  veins,  capil- 
laries and  arteries  of  the  lungs,  and  lastly  to  disease  of  the  right 
side  of  the  heart.  Here  there  is  a  different  starting  point,  but 
the  progress  of  the  disease-changes  in  a  direction  opposed  to  the 
course  of  the  circulation  is  the  same.  * 

The  disease  may,  however,  begin  with  the  auricles,  owing  to 
disease  of  the  auriculo-ventricular  valves  impeding  the  flow  of 
blood  into  the  ventricle,  or  to  simple  narrowing  of  the  auriculo-ven- 
tricular opening.  The  auricle  is  then  primarily  enlarged,  the 
corresponding  veins  congested,  this  is  propagated  to  the  capillaries 
and  arteries,  and  lastly  the  ventricle  on  the  opposite  side  of  the 
heart  is  involved.  This  is  chiefly  seen  with  fibrinous  deposits  on 
the  valves  or  in  the  ca.se  of  polypus  hanging  into  the  auriculo- 
ventricular  opening.  Aneurisms,  embolisms,  neoplasms,  athero- 
ma and  calcic  degeneration  of  the  arterial  walls  may  be  effective 
factors. 

In  addition  to  these  cau.ses  Bouilaud  and  Leblanc  attach  a  high 
importance  to  chronic  inflammations  of  the  .serous  membranes, 
which  by  reason  of  the  contiguity  of  the  latter  to  the  muscular 
.structure  bring  about  a  more  abundant  circulation  in  this  and  an 
increased  nutrition.  Another  cause  is  unintermitting  hard  work 
which  necessitates  excessive  exertion  of  the  heart,  to  supply 
blood  more  freely  to  the  muscular  system  and  the  lungs.  Many 
hunters  .suffer  from  this  affection  it  is  believed  because  of  their 
extraordinary  exertions.  The  stallion  Helenus  had  a  heart  of 
14  lbs. 

Weight  of  the  heart.  The  heart  in  the  lior.se  which  rarely 
weighs  over  9  lbs.  is  increa.sed  from  10  lbs.  to  14  lbs.  in  this  dis- 
ease and  in  one  case  in  a  cart  hor.se,  recorded  by  Stephen.son  in 
the  Veterinarian   for    iS6r,    it    is  said  to  have  reached    32    lbs. 


31 8  Veterinary  Medicine. 

Stephenson  probably  weighed  the  heart  while  filled  with  blood. 
A  diseased  heart  weighed  in  this  way  by  Thomson  amounted  to 
34  lbs.,  one  by  Gerlach,  19  lbs.,  an  ox's  heart  by  Herran  36  lbs. 
In  Stephenson's  case  there  was  further  an  extraordinary  dilatation 
of  the  anterior  vena  cara.  Haycock  (Veterinarian,  1850),  records 
a  case  in  which  though  the  heart  only  weighed  10  lbs.  8oz..  yet 
the  walls  of  the  ventricles  were  double  the  normal  thickness,  those 
of  the  left  being  2^  inches  while  those  of  the  right  were  i  inch. 
An  estimate  from  the  thickness  of  the  walls,  it  must  be  borne  in 
mind,  is  not  so  satisfactory  as  the  absolute  weight  taken  after  the 
removal  of  the  large  vessels,  the  superfluous  fat  and  the  contained 
blood. 

The  usual  coincidence  of  other  complaints  supports  the  state- 
ment that  it  is  mostly  due  to  obstruction  to  the  circulation.  A 
few  cases  will  illustrate.  Dyer  reports  the  case  of  a  hunter  in 
which  with  general  hypertrophy  and  dilatation  of  the  right  auri- 
cle, the  pulmonary  artery  was  so  large  as  to  admit  the  fist.  (Vet- 
erinarian, 1861).  Halloway  relates  a  case  in  which  there  were  ex- 
tensive internal  deposits  of  melanotic  material,  especially  in  the 
mesenteric  glands,  liver,  spleen,  and  kidneys  (Veterinarian,  1850). 
Haycock  records  a  case  with  thickening  of  the  auriculo  ventricu- 
lar valves  on  the  right  side,  and  of  several  of  their  tendinous 
cords,  also  a  diseased  liver  which  had  ruptured  before  death  (Vet- 
enarian,  1850).  Percivall  publishes  a  case  associated  with  pleu- 
risy and  rheumatism  (Veterinarian,  1858).  Henderson  furnishes 
a  case  associated  with  diseased  right  auriculo-ventricular  valves 
and  enlarged  liver  weighing  55  fts.  (Veterinarian,  1847.) 

Symptoms.  In  simple  hypertrophy  the  heart  beats  are  more 
forcible  and  prolonged  so  that  the  period  of  silence  or  rest  is 
shortened.  This  is  due  to  the  greater  length  of  time  taken  up  in 
the  contraction  of  the  ventricles.  For  the  same  reason  the  pulse 
which  mayor  may  not  be  accelerated,  irregular  or  intermittent,  is 
full  and  rolling  or  as  it  were  prolonged.  The  first  sound  of  the 
heart  is  prolonged  and  low  or  muffled,  sometimes  almost  inaudible 
while  the  second  is  unnaturally  loud.  Sometimes  when  one  ven- 
tricle only  is  enlarged  that  may  complete  its  contraction  later  than 
the  other  and  the  second  sound  is  repeated  as  in  the  syllables 
hib — tip  tip.  A  duplication  of  the  first  sound  only  is  less  com- 
mon.    If  the  sounds  are  heard  over  a  greater  extent  of  the  chest's 


Hypertrophy  of  the  Heart.  319 

surface  than  is  natural,  the  kings  being  healthy,  it  is  probably  due 
to  hypertrophy  of  the  heart.  If  very  clear  on  the  right  side  they 
indicate  increase  of  the  right  ventricle.  The  heart's  impulse  is 
usually  strong  and  may  be  felt  on  both  sides,  and  it  may  be  over 
the  whole  chest. 

Percussion  usually  shows  a  more  extended  dulness  in  the  re- 
gion of  the  heart  but  the  blows  must  be  pretty  forcible  to  bring 
out  the  deeper  resonance,  otherwise  it  will  come  only  from  the  thin 
layer  of  lung.  These  results  are  of  the  greatest  value  in  the 
dog. 

The  pulse  is  usually  regular  and  if  excited  to  irregularity  and 
intermission  quickly  returns  to  its  natural  state  when  the  patient  is 
left  at  rest. 

As  hypertrophy  is  usually  associated  with  dilatation  of  the  heart 
the  following  table  abridged  and  modified  from  Dr.  Walshe  will 
prove  valuable  by  presenting  side  by  side  the  signs  indicating  hy- 
pertrophy with  and  without  dilatation,  and  simple  dilatation. 


TABIvE    CONTRASTING   THE    MAIN    SYMPTOMS     OF     HYPERTROPHY 
,  AND    DILATATION. 

A.   General  Physical  Signs. 

SIMPLE     HYPERTROPHY.  HYPERTROPHY  WITH  DI-        SIMPL,E  DIIvATATION. 
NATATION. 

Heart's  impulse  slow  Force  increased, sharp-  Impulse  conve3S  a 
and  heaving  as  if  press-  er,  more  knocking,  may  feeble  undulatory  sensa- 
ing  steadily  against  an  impart  a  shake  to  the  tion  ;  force  of  successive 
obstacle — in  rythm  reg-  body.  May  be  felt  on  beats  unequal  ;  rythm 
ular,  in  force  unequal.      the  right  side.  irregular. 

First    sound     is- dull.      Sounds  gain  greatly  in      First      sound        short, 
muffled,    prolonged   and  loudness   and   extent  of  abrupt  and  clear.    Second 
weakened  almost  to  ex-  transmission,    especially  sound    not    specially   af- 
tinction.     Second  sound  if    the    valves    are    not  fected. 
full  and  clanging  ;  per-  thickened, 
iod  of  silence  shortened. 

Murmur  with  the  first  Murmur  with  the  first  Murmur  with  the  first 
sound  present  at  one  sound  may  be  present,  sound  from  insufficiency 
time  and  absent  at  an-  from  altered  direction  of  of  the  auriculo-ventricu- 
other.  the  orifice  of  the  aorta,     lar  valves. 


320  J^etcrinary  Medicine. 

B.   General  Functional  Symptoms. 

SIMPLE     HYPERTROPHY.  HYPERTROPHY'  WITH  DI-        SIMPLE  DILATATION. 
LATATION. 

Strength    unimpaired.      Strength   tends  to  be-      Strength  fails. 
Power  of  continued  exer-  come  impaired, 
tion    (especially   uphill) 
limited   by   shortness  of 
breath. 

Visible  mucous  mem-      Purplenessand  lividity      Lividity  of  the  mucous 

branes    healthy   or   of  a  of   the     mucous     mem-  membranes.        Dropsical 

l)rightred.  branes  proportionate   to  effusions  of  the  limbs  and 

the  valvular  or  pulmon-  other     dependent     parts 

ary  obstruction.  which  pit  on  pressure. 

Difficulty  of  breathing      Difficulty  of  breathing      Difficulty  of  breathing 

occasional.  occurs  in  paroxysms.         great  and  constant,  with 

occasional    aggravations. 

Pulse  full,  strong,  firm,       Fullness  of  pulse  con-       Pulse  small  and  feeble, 

tense,  resisting  and  pro-  tinues  but  strength  and  much  later  than  the  heart 

longed    without  jerk  or  power  of  resistance  lost.  beat.     Regular  or  feeble, 

thrill.  fluttering   and   irregular. 

Venous     pulse     in     the 

jugulars. 

Rarely  and  never  rap-       Indirectly  and  more  or      Palpitation       frequent. 

idly   the    direct  cause  of  less  rapidly  fatal.  Faintness     occurs     from 

death.  time   to   time,    and    may 

lapse   into    fainting    and 
sudden  death. 

Pure  hypertrophy  rarely  implies  imminent  danger  unless  de- 
pendent on  some  pre-existing  structural  disease  which  impedes 
the  freedom  of  the  circulation.  If  excessive,  however,  or  if  as- 
.sociated  with  dilatation  the  animal  is  short-winded  and  unfit  for  all 
but  the  slowest  work.  It  predispo.ses  to  congestion  or  apoplexy 
of  the  lungs  when  its  seat  is  the  right  ventricle,  and  to  conges- 
tions and  hemorrhage  in  other  parts  of  the  system,  brain,  kidney, 
lungs,  liver,  bowels,  if  in  the  left. 

Asthma  (dogs),  heaves  (horses),  emphysema  and  tuberculosis 
in  cattle  are  occasional  complications  attended  by  grave  symptoms. 

Treatment.  In  advanced  cases  and  .such  as  are  dependent  on 
irremovable  structural  changes  in  the  lungs  or  elsewhere  no  treat- 
ment is  of  any  avail.  In  recent  and  uncomplicated  cases  in  the  horse 
and  cow  and  in  some  more  advanced  conditions  in  other  animals, 


Hypertrophy  of  the  Heaj^t.  321 

not  used  for  work,  a  palliative  treatment  may  be  profitably  adopted. 
This  consists  in  a  nitrogenous  restricted  and  gently  laxative  diet, 
perfect  rest  in  fattening  oxen  and  other  animals,  or  in  the  horse 
moderate  and  carefully  regulated  work,  and  as  a  medicament  the 
use  of  digitalis  or  aconite.  No  known  remedy  has  any  power  to 
directly  check  the  growth  of  the  heart  and  the  utmost  that  can  be 
expected  of  these  agents  is  to  lessen  the  activity  of  the  heart's 
action  and  retard  its  growth.  Digitalis  may  be  given  as  recom- 
mended for  palpitation,  or  aconite  in  the  form  of  tincture  20  drops 
for  horses  and  cattle  and  i  to  2  drops  for  dogs,  repeated  four  times 
daily.  Strophanthus  may  replace  digitalis.  When  depletion 
seems  advisable  purgatives  or  diuretics  should  be  given  as  appears 
most  applicable  to  the  particular  case.  Iodide  of  potassium  has 
been  strongly  recommended, 

When  extreme  dilatation  exists  with  the  hypertrophy^  sedatives 
should  be  given  cautiously  and  their  effects  carefully  watched  as 
the  heart  is  often  dangerously  susceptible  to  depressing  influences. 
When  the  disease  has  advanced  so  far  as  to  cause  abundant  drop- 
sical effusions  it  is  futile  to  resort  to  treatment  as  amelioration  can 
rarely  be  looked  for,  not  even  to  the  extent  of  allowing  an  animal 
to  be  fattened. 

The  value  of  arsenic  in  most  cases  of  broken  wind  (heaves) 
has  suggested  the  inquiry  whether  it  does  not  operate  directly  on 
the  heart.  L,eblanc  who  advances  this  query  might  have  quoted 
in  explanation  the  known  power  of  arsenic  to  retard  and  arrest 
tissue  change,  with  its  natural  consequences,  the  diminished 
amount  of  effete  matter  thrown  into  the  blood  in  any  given  time, 
and  the  lessened  necessity  for  an  active  circulation  to  supply  any 
great  waste  of  structure.  It  may  benefit  such  cases  in  this  way 
but  does  so  probably  to  a  far  greater  extent  by  an  influence  on 
the  nervous  function  analogous  to  its  action  in  neuralgia  and 
other  purely  nervous  disorders.  Dilatation  of  the  heart  which 
usualb'^  exists  in  heaves  is  usually  benefited  by  tonics  which  like 
arsenic  are  destitute  of  stimulating  properties. 


ATROPHY. 

Simple,  eccentric,  concentric.  Usually  eccentric.  Causes,  effusion  in 
pericardium,  obstruction  of  coronary  arteries,  by  false  membranes,  etc., 
general  inanition.  Symptoms,  beats  weak,  sounds  loud,  clear,  decreased 
area  of  dulness  on  percussion,  pulse  slow,  weak,  under  excitement  unequal, 
irregular,  intermittent  with  palpitation,  dropsy  of  limbs,  etc.,  murmur  with 
1st  sound.     Treatment  only  in  early  stages  by  removal  of  the  cause. 

The  loss  of  substance  in  the  muscular  walls  of  the  heart  is 
either  swiple  when  there  is  no  change  in  the  capacity  of  its 
different  cavities  : — eccentric  when  the  chambers  of  the  heart 
are  enlarged  ;  or  concentric  when  these  chambers  are  reduced 
in  size.  Like  hypertrophy  it  may  affect  the  walls  of  one  chamber 
to  the  exclusion  of  the  others. 

Atrophy  is  much  less  frequent  in  the  lower  animals  than  hyper- 
trophy and  in  nearly  all  cases  on  record  it  was  associated  with 
dilatation. 

The  causes  are  not  always  very  evident.  Effusion  into  the  per- 
cardium  is  one  of  the  most  frequent,  the  compression  of  the  heart 
impairing  its  nutrition  and  decreasing  its  size.  Especially  is  it 
hurtful  when  several  layers  of  false  membranes  deposited  on  the 
surface  of  the  heart  become  organized,  preventing  its  sufficient 
dilatation  and  compres.sing  its  nutrient  blood-vessels.  A  case  of 
this  kind  in  a  dog  occurred  to  Eeblanc  ;  the  right  auriculo- ven- 
tricular opening  was  surrounded  by  thick  organized  layers  of 
fal.se  membranes  which  by  their  contraction  had  largely  di- 
minished the  opening  and  even  pressed  on  the  coronary  artery 
cutting  off  to  a  great  extent  the  supply  of  blood  to  the  walls  of 
the  ventricle.  Another  alleged  cause  is  a  prolonged  insufficient 
nourishment  to  the  entire  body.  Eeblanc  has  also  observed  this 
in  dogs  the  subjects  of  long  continued  wasting  maladies. 

Symptovis.  In  pure  atrophy  these  are  the  opposite  of  those 
seen  in  hypertrophy.  The  beats  of  the  heart  are  weak  or  inap- 
preciable to  the  hand  placed  on  the  side  of  the  chest  behind  the 
left  elbow.  The  sounds  of  the  heart  are  loud  and  clear,  their  in- 
tensity being  proportionate  to  the  thinning  of  the  walls  and  the 
dilatation  of  the  chambers.  Percussion  so  far  as  it  can  be  made 
effectual,  which  is  chiefly  in  dogs,  shows  a  diminished  area  of  dul- 
322 


Dilation  of  the  Heart.  323 

ness.  The  pulse  is  slow,  weak,  or  indistinct,  compressible,  be- 
coming accelerated,  unequal,  irregular,  and  intermittent  when  the 
patient  is  excited.  Palpitation  is  frequent,  breathing  is  difficult 
or  easil}^  embarrassed  and  there  is  a  tendency  to  dropsy  of  the 
limbs  and  dependent  parts.  These  symptoms  are  usually  associa- 
ted with  considerable  prostration  and  depression. 

These  are  often  complicated  by  symptoms  of  valvular  disease 
or  dilatation. 

Atrophy  progresses  slowly  and  rarely  causes  death  in  the  earlier 
stages.  In  its  advanced  stages  when  dropsy  has  supervened  little 
can  be  dene  even  in  its  mitigation.  In  the  earliest  stages  only 
can  good  be  done  by  employing  measures  calculated  to  remove 
its  causes  and  thus  put  a  stop  to  its  progress. 


DILATATION  OF  THE  HEART. 

Result  of  obstruction  to  circulation.  In  right  ventricle  usually.  In  au- 
ricle from  narrow  auriculo-ventricular  opening.  Pure  dilatation  from  sud- 
den extreme  blood  pressure  as  in  inflammations  of  the  lungs.  In  fat  cattle 
from  fatty  obstructions  around  the  heart  and  great  vessels.  Weakness  of 
cardiac  muscles  in  fatty  degeneration,  fevers,  debility,  etc.  Symptoms, 
dyspnoea  under  slight  exertion,  unsteady  walk,  cold,  dropsical  limbs,  venous 
pulse,  pulse  small,  weak,  irregular,  intermittent,  with  palpitations.  Treat- 
ment, in  early  stages  arrest  the  causes,  arsenic,  digitalis,  fatten  for  butcher. 

Dilatation  of  the  right  cavities  of  the  heart  is  one  of  the  most 
common  heart  diseases  of  the  horse.  It  is  an  almost  constant 
condition  in  advanced  broken  wind,  and  is  a  frequent  concomitant 
of  hypertrophy  and  an  occasional  one  of  atrophy  of  the  heart. 
Its  usual  direct  cause  is  some  obstacle  to  the  free  escape  of  blood 
from  the  cavity  affected.  Thus  in  broken  wind  the  difficulty  of 
the  circulation  through  the  lungs  causes  accumulation  in  the  pul- 
monary artery  and  right  ventricle  of  the  heart,  the  walls  of  which 
are  distended  because  of  the  unwonted  internal  pressure.  When 
the  dilatation  of  this  ventricle  reaches  a  certain  stage  the  auri- 
culo-ventricular opening  is  equally  widened,  the  valves  become 
insufficient  to  close  it  and  the  right  auricle  and  venae  cavae  par- 


324  Veterinary  Medicine. 

ticipate  in  turn  in  the  internal  pressure  and  dilatation.  The  right 
ventricle  is  more  often  affected  than  the  left,  because  of  the 
greater  frequenc}-  of  obstruction  in  the  circulation  through  the 
lungs  than  in  that  through  the  general  system,  and  because  of  the 
thinness  of  its  walls  which  more  readily  give  way  under  internal 
pressure.  Dilatation  may  result  from  disease  of  the  great  arteries, 
from  diminution  of  their  calibre  by  the  pressure  of  tumours,  or  by 
narrowing  of  their  openings  at  the  heart,  whether  as  the  result  of 
diseased  valves  or  other  morbid  condition.  As  affecting  the 
auricles  primarily  its  usual  cause  is  narrowing  of  the  auriculo- 
ventricular  opening  from  some  abnormal  deposit.  The  extreme 
thinness  of  the  walls  of  the  auricles  allows  these  to  give  way  un- 
der internal  pressure  even  much  more  readily  than  the  right 
ventricle. 

The  causes  it  will  be  seen  are  similar  to  those  inducing  hyper- 
trophy, and  hence  the  frequent  coexistence  of  the  two.  Pure 
dilatation  occurs  especially  when  internal  pressure  takes  place 
suddenly  and  to  excess,  and  while  the  nutritive  functions  are  to  a 
great  extent  in  abeyance.  Such  conditions  are  found  in  acute 
inflammations  of  the  respiratory  organs,  or  of  the  inner  or  outer 
membranes  of  the  heart,  and  the  rapid  deposit  in  the  lungs  of 
tubercles  or  other  abnormal  material. 

Dilatation  of  the  right  side  of  the  heart  is  a  common  complaint 
in  overfed  cattle,  and  is  apparently  due  to  the  diminished  power 
of  resistance  in  the  walls  of  the  heart,  the  muscular  substance  of 
which  is  partly  replaced  by  fatty  granules,  and  to  the  obstruction 
offered  to  the  circulation  by  the  extraordinary  accumulation  of  fat 
around  the  base  of  the  heart  and  the  commencement  of  the  large 
blood  vessels.  Though  a  diseased  condition  this  rarely  shortens 
life  or  interferes  with  the  uses  to  which  cattle  are  put. 

The  heart  walls  are  similarly  weakened  and  yield  more  readily 
to  the  internal  blood  pressure  in  endocarditis,  myocarditis,  peri- 
carditis, high  fever,  infectious  diseases,  poisonings,  anaemia,  and 
debilitating  diseases  generally.  Debility  and  incapacity  to  resist 
the  blood  pressure  is  the  essential  prerequisite  to  dilatation. 

The  sympto7ns  which  have  been  already  enumerated  in  the 
table  given  under  the  head  of  hypertrophy  are  mainly  these  :  Loss 
of  appetite,  spirit  and  endurance  ;  faintness  and  difficulty  of 
breathing  on  the  slightest    exertion  ;  habitual    coldness   with    a 


hiflammations  in  the  Heart.  325 

tendency  to  dropsy  of  the  extremities  ;  loss  of  control  over  the 
extremities  when  walked  or  trotted  far  ;  venous  pulsation  in  the 
jugulars  ;  heart's  impulse  weak  and  undulatory  or  tremulous,  or 
under  exertion  tumultuous  or  palpitating  ;  murmur  often  present 
with  the  first  sound  ;  the  first  or  more  commonly  the  second  sound 
may  be  doubled  ;  pulse  small,  weak,  irregular,  and  often  inter- 
mittent, and  frequently  livid  spots  in  the  nasal  mucous  membrane. 
Paroxysms  of  unsteady  gait  from  irregular  circulation  in  the 
brain  is  frequent,  and  Dyer  asserts  that  he  has  repeatedly  seen 
blindness  as  a  result  of  this  condition. 

In  treatment  the  main  purpose  should  be  to  put  a  stop  to  the 
cause  of  the  disease  before  it  has  been  developed  to  a  dan- 
gerous extent.  When  the  malady  is  manifested  by  the  symptoms 
above  enumerated  the  subject  is  rendered  permanently  unfit  for 
service  and  will  probably  die  suddenly  under  some  slight  exer- 
tion. Fattening  animals  in  a  condition  of  quietude  will  often  lay 
on  flesh  for  an  indefinite  length  of  time  notwithstanding  that  the 
heart  is  considerably  dilated.  (See  note  on  digitalis,  strophanthus 
and  arsenious  acid  in  dilated  heart,  under  the  head  of  hypertrophy') , 
To  relieve  the  asthmatic  attacks  attending  on  an  overtaxed  heart 
Zuill  strongly  recommends  the  combination  of  iodide  of  potassium, 
digitalis,  nux  vomica  and  coca.  But  heart  tonics  are  often  much 
more  affective  after  the  bowels  and  portal  system  have  been  un- 
loaded by  a  laxative. 


INFI.AMMATIONS  IN  THE  HEART. 

These  are  among  the  most  common  diseases  of  this  organ  and 
moreover  lead  to  many  of  the  changes  in  structure  to  be  hereafter 
noticed  so  that  it  is  convenient  to  treat  of  them  here.  According 
to  their  relative  frequency  they  may  be  ranged  : — ist.  Inflamma- 
tion of  the  external  covering  of  the  heart — pericarditis  ;  2d.  In- 
flammation of  the  internal  lining  membrane  of  the  heart — endo- 
carditis ;  and  3d.  Inflammation  of  the  muscular  substance  of  the- 
heart — carditis. 


PERICARDITIS. 

Definition.  Frequency  in  different  genera.  Causes,  rheumatic,  trauma- 
tism, extension  from  pleurisy.  Unwholesome  buildings  and  localities,  de- 
bility. Symptoms,  chill,  reaction,  pleuritic  symptoms,  hyperthermia,  ten- 
derness behind  left  elbow  only,  friction  sound  synchronous  with  heartbeat, 
later  it  is  lost  and  heart  sounds  are  muffled,  increased  area  of  dulness  on 
percussion,  oppressed  breathing,  venous  pulse,  patient  statant,  little  fever 
in  chronic  cases.  Traumatism  from  the  stomach,  digestive  disgrder,  grunt- 
ing, dropsy  under  the  sternum  with  little  fever  at  first.  Lesions,  as  in  pleu- 
risy, obliteration  of  pericardial  sac.  In  traumatism  from  stomach  the  for- 
eign body  is  formed  in  the  cardiac  end  of  a  band  of  lymph  extending  to  the 
reticulum.  Treatment,  in  chill,  after  reaction,  medicinal  measures  as  in 
pleurisy,  local  applications  to  the  region  of  the  heart.  Paracentesis,  inser- 
tion of  needle,  antiseptic  precautions.     Chronic  pericarditis  in  oxen. 

Definition.  Inflammation  of  the  .strong  fibro-serous  sac  in  which 
the  heart  is  contained  and  which  is  reflected  on  the  muscular  sub- 
stance of  that  organ  .so  as  to  form  it.s  external  covering. 

This  is  the  most  common  inflammatory  disease  of  the  heart  and 
has  been  met  with  more  frequently  in  horses  and  cattle  than  in  the 
smaller  quadrupeds. 

Causes..  It  frequently  coincides  with  or  follows  other  diseases 
sucli  as  influenza,  pleiiro-pneuinonia  and  above  all  rheui7iatism. 
In  cattle  and  goats  wounds  from  sharp  pointed  bodies,  (needles, 
pins,  nails,  etc.),  which  have  been  swallowed  with  the  food  and 
have  passed  through  the  walls  of  the  second  .stomach,  the  dia- 
phragm and  pleura  to  the  heart  constitute  a  frequent  cause  in  cat- 
tle. The  pericardium  has  been  punctured  by  a  fractured  rib  and 
has  been  implicated  in  inflammation  attendant  on  an  abscess  or 
other  lesion  in  the  walls  of  the  chest.  Besides  these  the  general 
influences  which  cau.se  uncomplicated  attacks  of  the  disease  are 
the  same  as  those  producing  pleurisy,  peritonitis,  rheumatism  and 
inflammation  of  serous  membranes  generally.  These  are  sudden 
changes  from  heat  to  cold,  cold  winds,  cold  draughts,  drenching, 
chilling  rains  in  animals  already  overheated  and  exhausted,  or 
prolonged  exposure  in  severe  weather,  in  low  states  of  the  sys- 
tem. Leblanc  ju.stly  remarks  that  "  with  the  morbid  influences 
which  appear  specific,  there  often  coincide  intemperate  seasons, 
326 


Perica  7'ditas.  327 

badl}^  arranged  buildings,  a  want  of  sufficient  attention  to  the 
conditions  of  health,  and  in  the  case  of  herbivora,  wet,  cold,  and 
badly  exposed  pastures.  "  In  other  words  whatever  deteriorates 
the  health  and  vitality  predisposes. 

Symptoms.  These  are  less  characteristic  than  in  man  owing  to  the 
smaller  portion  of  the  heart  exposed,  but  they  are  usually  marked 
enough  to  permit  a  recognition  of  the  disease.  Acute  form.  The 
affection  is  ushered  in  by  chill,  general  fever,  hyperthermia,  (103° 
to  104°),  staring  coat,  hot,  dry  mouth,  dilated  nostrils,  excited, 
difficult  breathing,  double  lifting  of  the  flank  with  each  expira- 
tion, the  existence  of  a  prominent  ridge  from  the  lower  end  of  the 
last  ribs  along  the  flank  to  the  outer  angle  of  the  hip  bone,  as  in 
pleurisy,  pinched,  anxious  expression  of  countenance,  fixed  eyes, 
accelerated,  full,  hard  and  often  wiry  pulse,  and  tenderness  when 
the  ribs  behind  the  left  elbow  are  pinched  or  struck.  The  same 
tenderness  is  noticed  particularly  in  the  ox  and  smaller  quadru- 
peds when  pressure  or  compression  is  made  beneath  the  breast 
bone.  Auscultation  over  the  lower  ends  of  the  fifth  and  sixth 
ribs  and  their  cartilages  detects  a  friction  or  rubbing  sound  in  the 
early  stages  and  until  liquid  has  been  thrown  out  into  the  pericar- 
dial sac.  This  sound  may  be  at  first  the  finest  possible  creaking, 
afterward  increasing  to  a  distinct  rubbing,  is  synchronous  with  the 
b^at  of  the  heart,  and  usually  with  the  first  sound.  It  is  distin- 
guished from  the  friction  sound  of  pleurisy  in  occurring  rythmi- 
cally  with  the  sounds  of  the  heart  and  not  with  thoss  of  breath- 
ing, and  from  sounds  produced  in  the  interior  of  the  heart  by  its 
absence  when  auscultation  is  made  over  the  carotid  or  other  large 
artery.  This  friction  sound  is  lost  when  serous  effusion  takes 
place  into  the  pericardium,  but  reappears  when  the  liquid  is  ab- 
sorbed in  the  process  of  recovery.  Until  effusion  takes  place  the 
impulse  of  the  heart  is  strong,  often  irregular,  in  force,  and  some- 
times accompanied  by  a  purring  tremor  or,  according  to  L,eblanc, 
a  metallic  tinkle. 

When  effusion  has  taken  place  the  pulse  is  weaker  and  softer, 
irregular  or  intermittent,  the  impulse  of  the  heart  is  weaker,  the 
friction  sound  is  lost,  and  the  area  of  dulness  corresponding  to  the 
heart  is  increased.  Percussion  shows  it  to  extend  higher  than 
three  inches  above  the  breast  bone  in  the  horse  and  more  than 
two  or  two  and  a  half  inches  transversely.     It  is  distinguished  from 


328  Veterinary  Medicine. 

the  effusion  of  pleurisy  in  this,  that  the  duhiess  is  confined  to  the 
anterior  part  of  the  chest,  having  the  outHne  of  an  inverted  cone, 
and  does  not  extend  backward  along  a  horizontal  line,  and,  in  soli- 
pedes,  in  not  showing  equally  on  both  sides.  In  the  smaller  ani- 
mals it  may  be  distinguished  by  not  always  occupying  the  de- 
pendent part  of  the  chest  when  the  animal  is  placed  in  different 
positions.  As  the  effusion  increases,  the  heart's  sounds,  previ- 
ously strong,  become  first  muffled,  then  more  and  more  distant 
until  they  may  become  altogether  imperceptible.  The  difficulty 
and  oppression  of  the  breathing  increases,  the  nose  is  protruded, 
the  eyes  more  rigidly  fixed,  and  the  face  more  haggard  ;  a  venous 
pulse,  apparently  due  to  the  compression  of  the  heart  and  large 
veins  by  the  fluid,  is  ssen  in  the  lower  ends  of  the  jugulars,  and 
the  animal  obstinately  stands  as  indeed  the  solipeds  do  all  through 
the  disease.  At  this  advanced  stage  dropsies  of  the  limbs,  sheath, 
and  other  dependent  parts  of  the  body  are  frequent. 

A  painful  cough  is  sometimes  though  by  no  means  invariably 
present  throughout  the  disease.  Emaciation  takes  place  rapidly 
and  in  the  more  acute  cases  death  ensues  in  five  to  eight  days.  A 
fatal  issue  may  be  delayed  until  after  three  weeks  or  the  affection 
may  merge  into  a  chronic Jorm. 

Chronic  Pericarditis  is  sometimes  seen  in  the  ox  without  any 
preceding  acute  attack.  This  is  manifested  by  the  local  symptoms 
without  the  accompanying  acute  fever.  Along  with  a  slight  fever, 
there  is  the  oppressed  breathing  aggravated  by  exertion,  the  weak 
irregular  or  intermittent  pulse,  the  weak  or  distant  heart  sounds, 
the  absence  of  respiratory  sounds  and  the  dullness  on  percussion 
over  a  space  represented  by  an  inverted  cone  at  the  anterior  part 
of  the  chest  on  each  side,  the  venous  pulse  in  the  neck  and  the 
general  tendency  to  dropsy. 

If  the  pericarditis  has  been  the  result  of  sharp  pointed  metallic 
bodies  swallowed  and  afterwards  making  their  way  to  the  heart,  it 
is  sometimes  preceded  by  eructations,  tympan}^,  difficulty  in 
swallowing  or  in  rumination,  and  by  dropsy  under  the  sternum,  but 
more  frequently  the  heart  symptoms  are  the  first  to  be  noticed. 
It  is  not  attended  by  the  high  fever  of  other  pericarditis. 

Post  Mortem  Appearances.  These  do  not  differ  materially  from 
those  of  pleurisy,  to  which  accordingly  the  reader  is  referred. 
The  effusions  and  false  membranes  are  of  course  localized  in  the 


Pericarditas.  329 

sac  of  the  pericardium.  A  frequent  termination  is  a  permanent 
adhesion  of  the  pericardium  througJiout  more  or  less  of  its  extent 
to  the  surface  of  the  heart.  In  cases  of  death  the  serous  effusion 
is  commonly  colored  with  blood  though  mostly  from  a.  post  mortem 
infiltration  of  blood  from  the  congested  lungs.  The  effusion  has 
been  known  to  measure  fifteen  litres  in  the  horse.  It  may  be 
purulent  or  combined  with  foetid  gases,  particularly  in  traumatic 
cases.  After  mild  attacks  white  patches  (milk  spots)  are  often 
left  extending,  it  may  be  only  through  the  pericardium  and  in 
other  cases  reaching  into  the  muscular  substance.  At  a  less  ad- 
vanced stage  the  false  membranes  are  yellow,  with  a  rough  or 
villous  surface,  they  may  be  softened  from  fatty  degeneration  or 
they  may  be  more  or  less  completely  calcified. 

When  the  cause  has  been  perforation  by  a  metallic  body,  it  wall 
be  found  surrounded  by  exudate  enveloping  a  canal  or  band  ex- 
tending to  the  diaphragm  or  stomach. 

Treatment.  Pericarditis  often  proves  fatal  but  it  is  by  no 
means  invariably  so  in  uncomplicated  cases.  There  is  especial 
danger  when  serous  effusion  is  excessive,  when  it  occurs  in  a 
weak  and  debilitated  subject,  or  when  it  is  complicated  by  pleurisy, 
influenza  or  rheumatism.  The  preliminary  chill  may  be  met  by 
the  measures  advised  for  the  rigor  of  pleurisy,  but  if  the  malady 
is  developed  other  treatment  is  required.  The  medication  is  still 
essentially  as  for  pleuris)^  only  the  primary  disease  (rheumatism, 
influenza,  pneumonia)  must  be  specially  attended  to  when  such  is 
present.  Acute  pain  may  be  met  by  carefully  graduated  doses  of 
opium  or  a-onite  and  by  the  moist  jacket  or  fomentations.  Some 
employ  icebags  to  soothe  at  once  inflammation  and  pain  and  in  the 
absence  of  rheumatism  these  may  be  resorted  to.  In  the  small 
animals  leeches  may  be  applied  over  the  cardiac  region.  Dry 
cupping  is  a  good  alternative  applicable  to  all. 

An  active  purgative  is  demanded  unless  the  affection  is  attended 
by  a  low  type  of  fever  or  has  occurred  during  the  course  of  an 
epizootic  disease  (Horse  5  to  7  drachms  aloes,  cow  i  to  2  lbs. 
Kpsom  Salts,  dog  i  oz.  castor  oil).  After  the  walls  of  the  chest 
have  been  well  fomented  they  may  be  enveloped  in  a  large  mustard 
poultice  which  must  be  continued  until  a  considerable  effusion 
has  taken  place  beneath  the  skin.  To  moderate  and  control  the 
heart's  action  give  digitalis  (horse  and  ox  ^  drachm,  dog  2  to  4 


330  Veterinary  Medicine. 

grains)  four  times  a  day.  After  the  purgative  has  acted  an  ounce 
of  nitrate  or  acetate  of  potass  may  be  given  daily  to  the  larger 
quadrupeds  (i^  drachms  to  sheep  and  pigs,  and  20  grains  to 
dogs)  in  the  drinking  water.  These  agents  together  with  the 
digitalis  must  be  pushed  to  the  largest  doses  when  the  effusion  has 
taken  place  abundantly  and  when  it  threatens  to  dangerously  in- 
terfere with  the  heart's  action.  Pilocarpin  is  a  dernier  resort,  to 
be  used  with  caution.  In  similar  circumstances,  ointment  or 
tincture  of  iodine  should  be  freely  applied  over  the  chest  in  the 
region  of  the  heart.  Mu.stard  and  other  vesicants  repeatedly 
applied  often  greatly  hasten  the  reabsorption  of  the  liquids. 

From  the  first  the  animal  must  be  warmly  clothed  and  every 
means  employed  to  obtain  free  circulation  and  warmth  on  the  sur- 
face. The  legs  must  be  well  rubbed  and  wound  in  warm  flannel 
bandages,  or  this  failing,  may  have  mustard  freely  applied  to  them. 
Warm  injections  must  be  at  the  same  time  thrown  into  the  rectum 
and  will  benefit  by  soliciting  the  action  of  the  bowels  as  well  as  in 
raising  the  temperature  of  the  surface  generally.  The  food  al- 
lowed should  be  warm  mashes  of  wheat  bran,  boiled  linseed  and 
similar  agents  in  small  quantities. 

If  the  amount  of  effusion  threatens  a  fatal  result,  it  may  be 
drawn  off  by  a  cannula  and  trochar  introduced  between  the  carti- 
lages of  the  fifth  and  sixth  ribs,  by  a  valvular  wound  and  with 
antiseptic  precaution  (see  hydrothorax),  care  being  taken  to  avoid 
puncturing  the  heart  itself. 

The  trochar  or  aspirator  needle  should  be  pushed  in  a  direction 
upward  and  inward  until  resistance  ceases  or  it  is  felt  that  the 
heart  has  been  touched.  A  caoutchouc  tube  may  now  be  attached 
to  it  and  allowed  to  depend  twelve  or  eighteen  inches,  and  its 
lower  end  should  be  plunged  in  a  weak  solution  of  boric  acid  or 
other  antiseptic.  This  avoids  the  entrance  of  air  and  insures 
against  the  introduction  of  serial  bacteria. 

When  the  vital  powers  are  being  exhau.sted  stimulants  mu.st  be 
given  to  support  the  animal,  combined  with  iodide  of  potassium. 
(See  advice  concerning  the  allied  condition  in  Hydrothorax) . 

In  the  chronic  pericarditis  of  oxen  the  fatality  is  greater.  Treat- 
ment consists  mainly  in  counterirritants  and  powerful  diuretics 
employed  in  doses  determined  by  the  strength  of  the  animal,  and 
combined  with  stimulants  and  tonics  as  in  the  advanced  stages  of 
the  acute  disease. 


Endocarditis.  331 

In  complicated  forms  of  percarditis  attention  must  be  given 
mainly  to  the  constitutional  affection;  thus  in  infljienza  a  stimula- 
ting and  supporting  treatment  is  demanded,  and  in  rheumatism 
colchicum,  acetate  of  potass,  salicylate  of  soda,  salol  and  similar 
agents  must  be  freely  administered,  though  not  to  the  exclusion 
of  counterirritants  to  the  region  of  the  heart,  and  other  measures 
demanded  bv  the  heart  diseases. 


ENDOCARDITIS. 

Definition.  Psthology  and  lesions,  congestion  of  the  endocardium  cover- 
ing the  valves,  valves  liable  through  friction  and  strain,  exudation  in  or  on 
the  serosa  rendering  it  opaque,  coagula  of  fibrine  on  the  surface, 
secondary  endocarditis  mycotic,  microbes,  changes  in  serosa,  distortions  and 
degenerations  of  valves.  Symptoms,  as  in  pericarditis,  with  violent  heart 
impulse  of  varying  force,  clear  metallic  sound,  blowing  murmurs,  weak 
pulse  decreasing  in  force,  irregular,  intermittent,  absence  of  local  tenderness, 
no  friction  sound,  no  increase  in  area  of  dulness,  if  lesions  are  in  right 
heart — venous  pulse,  venous  congestion,  dropsies.  Valve  lesions,  in  mitral 
valve — general  heart  symptoms  and  murmur  with  ist  heart  sound,  2d  sound 
may  be  repeated  and  exceptionally  a  venous  pulse — in  tricuspid  valve — 
same  with  constant  venous  pulse,  venous  congestion  and  dropsy  ;  narrow- 
ing of  the  mitral  orifice — general  heart  symptoms  and  blowing  murmur 
before  the  ist  sound  ;  narrowing  of  the  tricuspid  orifice — same  with  mur- 
mur sometimes  audible  on  the  right  side  ;  insufiiciency  of  aortic  valves — 
general  heart  symptoms  and  murmur  with  2d  heart  sound,  double  rushing 
sound  in  arteries  and  delay  of  pulse  beat  at  jaw  ;  lesions  in  pulmonary 
valves — same  but  without  double  rush  in  arteries,  or  delay  of  pulse  beat  at 
jaw.  Loose  coagula.  Embolism.  Causes,  as  in  pericarditis  and  strain  on 
valves,  and  poisons  and  microbes  in  the  blood.  Prognosis  grave.  Treat- 
ment, as  in  the  early  stages  of  pericarditis,  antirheumatics  and  germicides 
more,  and  diuretics  less  desirable.     For  clots  iodides,  alkalies. 

Definition.  Inflammation  of  the  serous  membrane  lining  the 
chambers  and  covering  the  valves  of  the  heart. 

Pathology  and  Morbid  Anatomy.  The  causes  and  symptoms 
will  be  better  understood  after  the  diseased  conditions  have  been 
comprehended.  The  earliest  changes  are  the  reddening  and  thick- 
ening of  the  lining  membrane  of  the  heart  but  above  all  of  that 
covering  the  valves.     The  valves  are  particularly  exposed  to  in- 


332  Veterinary  Medicine. 

flanimation  by  reason  of  the  friction  of  the  blood  when  violently 
forced  through  the  narrow  opening  in   excited  conditions  of  the 
heart,  by  the  strain  thrown  upon  them  from  the  violent  contrac- 
tions of  the  heart  or  the  recoil  of  blood  in  the  arteries,   and  by 
their  susceptibility  in  common  with  all  other  fibrous  structures  to 
rheumatic    inflammation.     The    redness   is    of   the    ramified   or 
branching  kind  characteristic  of  inflammation,  and  is  neither  re- 
movable by  washing  the  surface  nor  does  it  correspond  in  position 
with  the  colored  portion  only  of  a  clot  which  the  cavity  in   ques- 
tion m2iy  contain,  as  seen  in  bloodstaining  occurring  after  death. 
There  is  further  exudation  of  plastic  lymph  into  and  beneath 
the  serous  membrane,  rendering  it  opaque,  white  and  thick,  or  on 
its  surface  forming  granular  elevations,  and  in  the  case  of  the 
valves  becoming  moulded  into  ridges  or  festoons  by  the  mutual 
pressure  of  the  different   flaps  on  each  other.     The  inflamed  sur- 
faces are  further  liable  to  be  covered  by  masses  of  blood  clot  in 
successive  layers,   deposited  by   the  action  of  the  fibrinogenous 
matter  developed  in  the  inflamed  part.     These  clots  sometimes 
accumulate  in  considerable  masses,  firmly  adherent  to  the  heart's 
walls  or  valves   by  their  attached  surface,  but  soft   and  filamen- 
tous on  their  free  aspect.     These  clots  or  polypi,  as  they  have 
been  called,  are  soft  and  loose  on  their  free  surface,  and  become 
firmer  toward  their  points  of  attachment.     In  other  words  their 
consistency  is  in  direct  ratio  to  their  age.     If  of  old  standing  they 
are  usually  pale  yellow  or  white  and  streaked  with  red,  while  if 
recent  they  are  mostly  red  throughout.     They  vary  in  size  from 
a  thin  film  to  a  mass  filling  up  nearly  the  entire  cavity  in  which 
they  are  lodged,  and  as  they  frequently  extend  through  the  auri- 
culo-ventricular  openings  or  become  applied  against  this  or  the 
opening  of  the  great  artery,  they  seriously  and  sometimes  fatally 
interfere  with  the  circulation.     Leblanc  asserts  that  large  masses 
of  this  kind  may  be  deposited  in  a  few  days  or  even  hours,  caus- 
ing sudden  deaths,  and  especially  in  dogs.     He  has  found  other 
circumstances  than  endocarditis  to  cause  these  fibrinous  deposits, 
and  especially  the  absorption  of  pus,  or  the  sudden  suppression 
of  a  long  standing  discharge,  as  in  catarrh  of  the  air-passages. 
If  death  does  not  immediately  ensue,  these  fibrinous  deposits  may 
become   vascular,    as   is   the  case  with   false  membranes  in  the 
the  pleurae,  becoming  organized   into  fibrous  tissue,  or  even  de- 


Endocarditis.  333 

generating  into  calcareous  matter,  necrotic  debris,  or  pus,  several 
instances  of  which  as  occurring  in   horse  and  cow  are  on  record. 

These  cases  illustrate  endocarditis  by  irifection  {mycotic,  via- 
lignant,  or  idcerative  endocarditis^ ,  which  occurs  independently, 
or  as  an  extension  of  a  bacteridian  disease,  primarily  localized 
elsewhere  in  the  system.  Thus  it  is  a  secondary  lesion  in  infec- 
tious omphalitis,  pneumonia,  pleurisy,  arthritis,  abscess,  pyaemia, 
etc.  Beside  the  general  lesions  of  endocarditis  and  a  great  ten- 
dency to  molecular  death  of  the  new  formations  and  the  under- 
lying tissues,  there  is  the  presence  of  specific  germs  which  have 
been  the  occasion  of  the  disease.  Among  these  the  staphylococ- 
cus pyogenes  aureus,  the  streptococcus  pyogenes,  and  the  diplo- 
coccus  pneumoniae,  have  been  particularly  noted.  In  case  the 
valves  were  already  diseased,  they  become  especially  liable  to  be 
colonized  b}'  any  such  bacteria  that  may  be  circulating  in  the 
blood. 

In  the  early  stage  there  may  be  a  mere  swelling  of  the  valves, 
with  as  yet  a  smooth,  unbroken  surface,  but  with  enlargement 
and  increase  of  the  connective  tissue  cells,  later  fungous  vegeta- 
tions start  out  from  the  surface,  and  on  these  the  fibrine  of  the 
blood  is  deposited  in  layers. 

Besides  the  formation  of  clots  on  their  surfaces  other  changes 
occur  on  the  cardiac  valves  as  the  result  of  inflammation.  The 
organization  of  the  exuded  lymph  within  and  upon  them  leads  to 
rigidity,  loss  of  elasticity,  unevenness  of  their  surface,  contrac- 
tion and  puckering  so  that  the}^  can  no  longer  approximate  to 
each  other,  but  leave  the  orifice  imperfectly  closed.  They  may, 
moreover,  have  gristle  or  bone  deposited  in  their  substance.  The 
osseous  degeneration  of  such  new  products  appears  to  be  the  most 
common  cause  of  those  ossifications  of  the  heart,  of  which  speci- 
mens are  to  be  found  in  nearly  all  veterinary  museums. 

Chronic  valve  disease  is  thus  found  to  be  a  common  result  of 
endocarditis,  and  from  the  obstacle  presented  to  the  flow  of  blood 
through  the  different  cardiac  orifices  by  the  rigid,  inelastic  and 
distorted  valves,  hypertrophy  of  the  heart  frequently  supervenes. 

In  our  domestic  quadrupeds  ante-mortem  clots  and  fibrinous 
polypi  have  been  chiefly  formed  in  the  right  side  of  the  heart, 
and  di.seased  valves  in  the  left. 

Symptojns.     The   general   symptoms  agree  in  many   respects 


334  Veterinary  Medicine. 

with  those  of  pericarditis.  There  are  the  same  general  symptoms 
of  fever  (temperature  102°  to  106°),  the  same  pinched,  anxious 
countenance,  the  same  shortness  of  breath  and  oppression  when 
moved,  the  same  violent  heart's  action,  and  the  same  rapid,  ex- 
citable pulse  tending  to  be  irregular  and  intermittent.  Among 
the  more  specific  symptoms  are  a  very  violent  impulse  of  the 
heart  against  the  left  side,  varying  in  force,  however,  in  succes. 
sive  beats  ;  a  metallic  tinkling  accompanying  the  impulse  and 
sometimes  heard  at  some  little  distance  from  the  body,  a  blowing 
murmur  as  soon  as  the  changes  in  the  valves  render  them  insuffi- 
cient to  close  the  orifices,  and,  if  the  obstruction  exists  on  the 
right  side,  venous  pulse,  general  venous  congestion,  and  dropsical 
swellings. 

The  pulse  may  at  first  have  considerable  force  but,  as  insuffi- 
ciency of  the  valves  ensues,  it  becomes  small  and  weak,  its  weak- 
ness forming  a  most  marked  contrast  to  the  violence  of  the  heart's 
impulse  against  the  side.  The  irregularity  and  intermission  of 
the  pulse  is  to  be  ascribed  at  first  to  the  impaired  nervous  energy 
of  the  heart  though  later  it  is  often  due  to  the  obstacle  presented 
by  clots  to  the  flow  of  blood  from  the  heart,  so  that  a  beat  some- 
times takes  place  without  a  corresponding  pulsation.  It  may 
reach  80  or  160  per  minute  in  horse  or  ox. 

The  blowing  murmur  when  heard  is  one  of  the  most  character- 
istic symptoms  but  must  be  carefully  distinguished  from  other 
allied  heart  sounds.  If  very  loud  it  may  be  confounded  with  the 
friction  sound  of  pericarditis,  but  may  be  differentiated  by  its  in- 
variable coincidence  with  some  particular  portion  of  the  heart's 
beat.  The  absence  of  local  tenderness  is  another  distinctive 
symptom.  Again  in  pericarditis  effusion  takes  place  early  annul- 
ing  friction  sound,  and  diminishing  alike  the  impulse  and  the 
sounds  of  the  heart. 

It  is  of  less  practical  value  to  be  able  to  distinguish  the  precise 
seat  of  the  murmur,  yet  the  following  data  will  guide  to  such  a 
conclusion. 

Simple  induration  or  insufficiency  of  the  Left  Auriculo 
ventricular  (Mitral)  valve.  Paroxysms  of  palpitation,  op- 
pression, and  difficulty  of  breathing;  vertigo  with  loss  of  control 
over  the  limbs  and  vacilating  gait  ;  stupor,  coma  ;  slight  tremor 
and  blowing  lioise  with  the  first  sound  of  the  heart  ;  heart's  im- 


Eiidocardiiis.  '  335 

pulse,  violent,  but  irregular  in  force,  sometimes  double  ;  pulse 
feeble,  irregular,  unequal,  or  intermittent  ;  sometimes  though  not 
at  all  constantly  a  venous  pulse  in  the  lower  end  of  the  jugulars. 
In  chronic  induration  of  this  valve,  or  in  osseous,  or  cartilagino- 
ous  degeneration  the  same  symptoms  are  shown.  The  more  gen- 
eral symptoms  may,  hovvever,  require  exercise  to  develop  them. 

Induration,  etc.,  of  the  Right  Auriculo- Ventricular  (tri- 
cuspid) valve.  The  symptoms  are  almost  identical  with  the  last. 
Venous  pulse  is  constant,  and,  particularly  after  exertion,  the 
veins  generally  are  distended.      Dropsies  are  more  common. 

Narrowing  of  the  Mitral  orifice.  In  addition  to  the  same 
general  symptoms  as  the  last  named  lesions,  there  is  a  sighing, 
blowing,  purring  or  rasping  sound,  according  to  the  degree  of 
narrowing,  heard  before  the  fir.st  sound  of  the  heart.  It  is  the 
noise  of  the  blood  rushing  through  the  narrowed  orifice  between 
auricle  and  ventricle.  It  is  usually  loudest  behind  the  middle  of 
the  shoulder  on  the  left  side.  Feeble  pulse,  frequent  imminence 
of  suffocation  and  filling  of  the  limbs,  etc.,  are  nearly  constant. 

Narrowing  of  the  Tricuspid  orifice  Symptoms  nearly 
identical  with,  the  last.  Venous  pulse  more  con.stant.  Blowing 
murmur  sometimes  loudest  on  the  rig  Jit  side  of  the  chest. 

Induration  or  insufficiency  of  the  aortic  valves.  Blowing 
murmur  with  the  second  sound  of  the  heart.  Double  ru.shing 
sound  in  the  carotid  with  each  heart's  beat.  There  is  an  apprecia- 
ble interval  between  the  beat  of  the  heart  and  corresponding  pul- 
sation at  the  jaw. 

Induration  or  insufficiency  of  the  pulmonary  valves.  Blow- 
ing murmur  with  the  second  heart  sound,  but  no  corresponding 
double  sound  in  the  carotid,  nor  any  marked  retarding  of  the 
pulse. 

Loose  coagula  in  the  heart  or  adherent  ones  {polypi)  produce 
one  or  other  of  the  above  class  of  symptoms,  according  to  the 
particular  orifice  they  tend  to  block  or  the  valves  whose  function 
they  impair. 

Anaemia  and  leukaemia  may  have  blowing  murnuirs  with  the 
finst  or  second  heart  sound. 

Embolism.  Plugging  of  arteries.  Another  class  of  symp- 
toms sometimes  supervenes  becau.se  of  loose  clots  being  washed 
on  into  the  arteries,  and  blocking  them   when  they  reach  those 


336  Veterinary  Medicine. 

that  are  too  small  to  transmit  them.  These  sj-mptoms  will  be  as 
varied  as  the  organs  whose  arteries  are  plugged.  If  in  the  brain 
there  ^may  be  dulness,  stupor,  vertigo,  somnolence,  delirium  ;  if 
in  the  liver,  biliary  and  digestive  derangement  ;  if  in  the  lungs, 
cough  with  the  other  signs  of  pneumonia  and  abscess  ;  and  if  in 
the  limbs  lameness  and  paralysis,  (brought  on  or  aggravated  by 
exercise,  and  often  removed  by  a  few  minutes'  rest),  wasting  of 
the  muscles,  etc.      (^See  Embolism) . 

Causes.  These  are  in  the  main  the  same  as  those  of  pericarditis. 
Weak  health,  exposure  to  extremes  of  weather,  punctures  with 
foreign  bodies,  but  above  all,  the  rheumatic  constitution  are  com- 
mon causes.  Indeed  rheumatism  appears  more  prone  to  attack 
the  serous  membrane  lining  the  heart  cavities  than  that  envelop- 
ing it  externally.  One  reason  for  this  is  to  be  found  in  the  great 
and  incesssantly  recurring  strain  on  the  fibrous  structure  of  the 
valves,  and  particularly  in  hard  worked  horses  and  hunting  dogs 
in  which  the  strain  is  often  extreme.  It  has  been  argued  that 
the  increased  blood  pressure  caused  by  digitalis  is  an  appreciable 
cause.  Its  frequent  coiniection  with  rheumatism  is  shown  in  the 
rheumatic  lesions  of  joints  and  fibrous  structures  seen  in  carcasses 
dead  of  endocarditis. 

Diseases  in  the  muscular  substance  of  the  heart  as  cysts,  ab- 
scess, etc.,  frequently  extend  to  the  endocardium. 

Among  other  causes  must  be  mentioned  disease-changes  in 
the  blood.  These  may  act  on  the  valves  directly  as  in  the  case  of 
lactic  acid  injected  by  Dr.  Richardson,  into  the  peritoneum  with 
the  view  of  producing  rheumatism  and  successfull}'  as  regards 
the  lesions  of  the  cardiac  valves  ;  or  indirectly  by  determining 
coagulation  and  irritation  of  the  lining  membrane  coming  into 
contact  with  the  clot.  The  very  fibrinous  and  plastic  state  of  the 
blood  in  extensive  inflammations  is  a  probable  cause  of  the  occur- 
rence of  clots  in  the  heart,  and  the  frequency  of  such  clots  in  the 
dog  has  been  ascribed  to  the  plasticity  of  his  blood  (Leblanc). 
The  injection  of  pus  into  the  blood  or  the  absorption  of  microbes 
from  diseased  surfaces  will  sometimes  produce  ulcerative  disease 
of  the  valves.  The  same  is  true  as  regards  the  germs  of  ompha- 
litis, pneumonia,  arthritis  and  other  infectious  diseases. 

lyafosse  records  certain  cases  of  endocarditis  due  to  extension 
of  the  disease  from  inflamed  veins. 


Endocarditis.  337 

Prognosis.  Endocarditis  is  always  attended  with  great  danger 
to  life,  but  it  is  more  likely  to  terminate  in  chronic  valvular  dis- 
ease which  quite  unfits  the  animal  for  useful  work.  Mild  cases 
may  terminate  in  complete  recovery. 

Treatment.  This  is  in  the  main  the  same  as  that  adopted  in 
the  early  stages  of  pericarditis.  Absolute  rest  is  of  prime  impor- 
tance. I^axatives,  sedatives  and  counterirritants  are  to  be  mainly 
relied  upon.  Belladonna  and  chloroform  on  the  chest  behind  the 
left  elbow  may  be  used.  As  there  is  not  the  same  danger  from 
effusion,  diuretics  need  not  be  pushed  to  the  same  extent.  Digi- 
talis must  be  avoided  if  possible  until  the  high  fever  subsides. 
In  infective  cases  quinia,  salicylate  of  soda,  salol,  or  hyposulphite 
of  soda  may  be  given.     L,ater  give  tincture  of  muriate  of  iron. 

In  rhemuatic  cases,  treat  as  for  an  acute  attack  of  rheumatism. 
Frequent  large  doses  of  salicylate  of  soda  or  salol,  large  doses  of 
acetate  of  potass  and  colchicum,  warm  clothing  and  counter- 
irritants  to  the  region  of  the  heart  are  especially  demanded. 
(See  Rheumatism.) 

When  clots  are  suspected,  and  when  endocarditis  threatens  to 
lapse  into  the  chronic  form,  it  is  recomended  to  give  iodide  of 
potassium  (horse  and  ox  i  drachm,  dog  5  grains,  twice  daily) 
with  carbonate  of  ammonia  or  of  potass  and  bitter  tonics.  A 
lengthened  rest  after  apparent  recovery  is  essential  to  avoid  per- 
manent valve  lesions. 


CARDITIS.     MYOCARDITIS. 

Definition.  Rare.  Complicates  pericarditis  and  endocarditis,  wounds  of 
tha  heart,  and  tubercular  and  other  deposits.     Symptoms.     Treatment. 

Definition.  Inflammation  of  the  nniscnlar  substance  of  the 
heart. 

This  is  a  rare  affection  and  is  necessarily  limited  to  a  small  por- 
tion of  the  heart's  stibstance,  otherwi.se,  the  cardiac  contractions 
must  cease  in  obedience  to  the  general  law  that  the  normal  func- 
tion of  an  inflamed  organ  is  for  the  time  abolished.  It  is  mainly 
seen  as  a  concomitant  of  endocarditis  or  pericarditis,  and  extends 
only  to  the  superficial  muscular  layers  ;  or  it  results  from  a  wound 
as  in  the  penetration  of  the  heart  by  a  needle  or  other  sharp- 
pointed  body  and  is  then  equally  circumscribed.  It  has  been 
seen  as  a  complication  in  infectious  di.seases — aphthous  fever, 
pyseinia,  septicaemia,  pneumonia  and  tuberculosis. 

The  evidences  of  the  existence  of  carditis  are  chiefly  the  lesions 
met  with  after  death,  ist,  The  existence  of  abscesses  in  the 
heart's  substance  associated  with  polypus  (Gowing,  Leblanc, 
etc.,)  or  otherwise  (Reynal).  Also  diffu.se  .suppuration  in  the 
heart's  substance  (Puze,  etc.)  2nd,  Softening  of  the  muscular 
substance  a  state  occasionally  met  with  when  an  animal  has  died 
of  ruptured  heart.  3d,  Ulceration,  of  the  walls  of  the  heart  as 
reported  by  Mercier  in  a  case  of  endocarditis.  4th,  Transforma- 
tion, and  induration  of  the  heart's  substance  whether  into 
fibrous  tissue,  cartilage  or  bone.  This  last  condition  of  the  walls 
of  the  right  auricle  and  ventricle  has  been  repeatedly  seen  in  old 
horses,  the  change  being  in  certain  cases  so  extensive  that  one  is 
left  in  wonder  as  to  how  circulation  could  have  been  carried  on. 
Three  specimens  of  this  kind  were  preserved  in  the  museum  of 
the  Alfort  Veterinary  College,  Paris,  and  the  Royal  Veterinary 
College,  London.  I^afosse  records  two  cases  of  gangrene  of  the 
internal  layers  of  muscle  in  endocarditis. 

The  symptoms  are  those  of  acute  heart  disease  generally  modi- 
fied somewhat  by  the  precise  location  of  the  inflamed  spot,  and 
treatmeiit  need  not  differ  materially  from  that  applied  for  inflam- 
mation of  the  investing  membranes,  inner  and  outer,  and  for  the 
infectious  disease  which  it  complicates. 
338    • 


CHRONIC  VALVULAR  DISEAvSE  OF  THE  HEART. 

This,  as  already  noticed,  is  a  common  result  of  endocarditis, 
the  valves  being  most  obnoxious  to  disease  in  such  cases.  The 
symptoms  are  those  mentioned  under  endocarditis  as  character- 
izing disease  of  the  different  valves,  such  as  incapacity  for  exer- 
tion, difficult  breathing,  palpitation,  irregularity  or  intermission 
of  pulse,  venous  pulse,  abnormal  heart  sounds,  unsteadiness  of 
the  limbs  when  driven,  and  dropsical  swellings  in  the  limbs  and 
elsewhere.  The  reader  is  referred  to  endocarditis  for  particulars, 
it  being  borne  in  mind  that  these  symptoms  are  not  in  this  case 
associated  with  fever. 

Horses  affected  in  this  way  are  useless.  Cattle  may  sometimes 
be  partially  fattened  by  preserving  them  from  all  sources  of  ex- 
citement, by  keeping  the  bowels  regular  and  by  combating  any 
paroxysms  with  sedatives,  such  as  aconite,  veratrum,  hydrocyanic 
acid,  or  opium,  and  with  digitalis. 


339 


FATTY  DEGENERATION  OF  THE  HEART. 

Causes,  improvemeut  in  the  direction  of  easy  fattening,  inactive  life,  best 
breeds  of  butcher  cattle  and  pigs  sufTer.  Symptoms,  weak,  irregular,  inter- 
mittent pulse,  palpitation,  unfitness  for  exertion,  general  heart  symptoms. 

In  addition  to  the  fibrotis  and  bony  transformations  to  which 
the  substance  of  the  heart's  walls  is  subject,  a  fatty  metamorphosis 
is  frequently  met  with.  In  most  cases  the  fat  accumulates  in 
great  masses  externally,  but  in  others  the  muscular  tissue  has  to 
a  greater  or  less  extent  lost  its  natural  structure  and  fatty  granules 
have  taken  the  place  of  the  sarcous  elements.  In  overfed  oxen 
the  right  cavities  of  the  heart  rarely  escape  dilatation,  and  this 
condition  is  very  often  accompanied  by  the  fatty  change. 
Virchow  has  shown  that  highbred  English  pigs  imported  into 
Germany  are  subject  to  a  similar  affection  of  the  heart  and  of  the 
entire  muscular  system.  It  may  occur  during  wa.sting  diseases 
and  from  phosphorous  poisoning. 

The  symptoms  are  weak,  irregtilar  and  intermitting  puke,  pal- 
pitation on  excitement,  weakness  of  the  heart's  impulse  in  the 
intervals,  incapacity  for  exertion,  sighing,  Cheyne-Stokes  respira- 
tion, loss  of  control  over  the  limbs  when  hurriedly  driven  and 
tendency  to  dropsy.  It  is  often  associated  with  dilatation,  is  rarely 
distinguishable  from  it  in  life,  and  is  equally  beyond  remedial 
measures.  The  feeding  animals  most  commonly  affected  can 
usually  be  fattened  if  removed  from  all  sources  of  excitement. 
In  case  of  phosphorous  poisoning  improvement  takes  place  when 
the  poison  is  stopped. 


340 


NEW  FORMATIONS  IN  THE   HEART.     TUMORS. 
PARASITES. 

Glanders,  abscess,  melanosis,  tubercle,  polypus,  nsevus,  parasites— echino- 
coccus,  cysticercus  tenuicollis,  cysticercus  cellulosa,  trichina,  sarcocyst, 
filaria  immitis,  strongylus  subulatus,  strongylus  vasorum. 

I  St.  Deposits  of  Glanders.  In  many  cases  of  glanders  and 
farcy  in  horses  the  specific  product  is  deposited  in  the  heart  as 
well  as  in  other  internal  organs.  Such  deposits  are  small  but 
numerous,  infiltrating  the  muscular  tissue  ;  their  cut  surface  is 
dry,  finely  granular  and  of  a  yellowish  white  color. 

2d.  Abscesses  are  sometimes  formed  in  the  heart  from  the 
colonization  of  microbes  from  suppurating  surfaces. 

3d.  Cancer  of  the  heart  has  been  noticed  chiefly  in  dogs  by 
Leblanc.  It  occurs  only  consecutively  to  cancer  in  other  parts  of 
the  body,  yet  it  has  sometimes  acquired  considerable  dimensions 
and  interfered  materially  with  the  movements  of  the  heart. 

4th.  Melanosis  of  the  heart  has  been  repeatedly  noticed  in  the 
horse.  Some  if  not  all  such  cases  .should  be  classed  with  cancers, 
as  these  internal  deposits  of  black  coloring  matter  in  solipedes, 
have,  in  our  experience,  mostly  possessed  malignant  characters, 
though  they  are  usually  simple  tumors  as  developed  in  the  skin  of 
the  horse.  These  black  masses  usually  project  beneath  the  pericar- 
dium or  endocardium. 

5tli.  Tuberculous  deposits  have  been  met  with  in  the  sub- 
stance of  the  heart  in  cases  in  which  the  lungs  or  other  organ  were 
the  seat  of  this  disease. 

6th.  T\i^  fibrous  growths  ox  polypi  due  to  the  deposition  and  or- 
ganization of  fibrinous  material  from  the  blood  have  been  referred 
to  under  endocarditis . 

7th.  Ganigee  reports  the  existence  of  a  vascular  tumour  of  the 
right  ventricle  of  a  horse  in  the  museum  of  the  Turin  Veterinary 
School.  It  consisted  of  varicose  veins  ramifying  beneath  the  en- 
docardium which  in  its  turn  was  healthy. 

8th.  The  parasites  found  in  the  heart  are  various,  a.  One, 
the  Echinococcus  Veterinorum,  has  been  repeatedly  found  in 
the  substance  of  the  heart  or  projecting  from  its  inner  or  outer  sur- 

341 


342  Veterinary  Medicine. 

face.  b.  Another,  the  cysticercus  tenuicollis,  has  been  met 
with  in  the  pericardial  sac  of  a  calf  (Reed),  c.  A  third,  the 
cysticercus  cellulosa  infests  the  muscular  structure  of  the  heart 
of  measly  pigs.  d.  The  heart  like  other  voluntary  muscles  of 
hogs  occasionally  contains  trichina  spiralis,  e.  Rainey's  cysts 
(sarcocysts)  are  microscopic  ovoid  bodies  usually  found  in  the 
hearts  of  oxen  and  other  animals.  /.  A  round  worm ,  filaria  immi- 
tis.  first  described  as  filaria  papillosa  haematica  by  Delafond  and 
Gruby,  lives  in  the  blood  of  the  dog,  is  one  millimeter  thick  by  fif- 
teen to  30  centimeters  long.  It  may  obstruct  the  pulmonary  artery 
(Serres)  or  the  mitral  orifice  (Silvestre).  It  may  cause  various 
nervous  disorders  and  even  sudden  death.  Its  mode  of  entrance 
is  unknown,  g.  Strongylus  Subulatus,  i  to  2  mm.  long  by 
70  to  90  //.  in  thickness  was  found  in  numbers  in  a  nodule  of  a 
dog's  lung,  and  the  dorsal  vein  of  the  penis  of  a  dog  (Leisering). 
h.  Strongylus  Vasorum  in  the  right  auricle  and  ventricle  of  a 
dog,  in  pea-hke  blood  clots.  It  is  14  to  21  mm.  long  by  i  m.  in 
thickness  (Serres). 


RUPTURE  OF  THE  HEART. 

In  the  lower  animals  ruptures  of  the  heart  have  been  observed 
as  the  result  of  (a)  extraordinary  exertion,  (b)  violent  concussion, 
and  (c)  ulceration  and  degeneration.  The  rupture  of  the  fatty 
heart  in  the  lower  animals  is  not  common. 

Rupture  during  severe  exertion  occurs  in  the  perfectly 
healthy  heart.  The  ruptures  take  place  in  the  weakest  point,  and 
most  commonly  in  the  fibrous  ring  which  encircles  the  base  of  the 
heart  and  attaches  the  great  aorta.  This  is  occasionally  seen  to 
happen  in  very  spirited  horses  during  a  severely  contested  race  or 
when  a  heavy  load  is  being  dragged  up  hill.  Percivall  mentions 
the  case  of  a  horse  at  a  Woolich  racing  meeting,  which  had  just 
lost  a  heat  by  half  a  head  and  which  died  just  after  passing  the 
winning  post,  with  ruptured  right  auricle. 

Cases  occur  during  coitus  (Hering),  tympany  (Anacker, 
Mayer,  Perdan)  and  operations  (Stockfleth). 

Rupture  from  Concussion  more  frequently  implicates  the 
muscular  walls  which  have  not  the  same  power  of  resistance  when 
they  receive  the  blow  in  a  relaxed  condition.  Parker  met  with  a 
case  of  rupture  of  the  right  auricle  at  its  base  or  at  the  line  of  its 
union  with  the  ventricle.  The  subject  was  a  pony  which  ran 
away  down  hill  and  struck  his  right  shoulder  violentlj^  against  a 
cart  wheel.  In  other  instances  the  rupture  takes  place  in  the 
posterior  vena  cava,  and  particularly  if  its  walls  have  been  the 
seat  of  disease.  Gamgee  found  rupture  of  the  commencement  of 
the  azygos  vein  in  oxen  killed  by  pithing  in  the  slaughter  houses 
of  Ferrara,  and  Professor  Maffei  subsequently  found  that  out  of 
3095  oxen  killed  in  these  abattoirs  57  had  this  vein  ruptured. 
Gamgee' s  explanation  of  the  occurrence  is  that  "the  instant  the 
animals  are  pithed  the  wal's  and  contents  of  the  chest  become 
paralyzed,  the  heart  becomes  an  inert  bag  filled  with  fluid,  the 
jerk  of  which  as  the  animal  falls,  causes  rupture  of  the  contain- 
ing vessel  at  its  weakest  part  and  this  is  in  truth  the  vena  azygos 
whose  walls  are  thin  and  only  protected  externally  by  the  pleura." 
Hertwig  gives  other  cases  resulting  from  falls. 

Perforation  of  the  heart  from  ulceration  is  sometimes  seen 

343 


344  Veterinary  Medicine. 

in  cows  when  sharp-pointed  metallic  bodies  from  the  stomach 
make  their  way  into  its  substance.  An  alleged  case  of  rupture 
following  ulceration  of  the  walls  of  the  right  ventricle  is  recorded 
by  Gaullet. 

Inflammation,  softening,  fatty  and  calcareous  degeneration, 
dilatation,  atheroma,  and  the  presence  of  parasitis  in  its  substance 
render  the  heart  more  friable  and  predispose  to  rupture. 

Lesion.  The  rupture  is  often  at  the  fibrous  ring  encircling  the 
aorta  or  pulmonary  artery  ;  in  other  cases  in  the  muscular  wall  of 
ventricle  or  auricle. 

Symptoms.  Death  may  be  practically  instantaneous.  If  de- 
layed there  is  hurried  breathing,  anxiety,  weakness,  pallor  of  the 
mucous  membranes,  staggering,  trembling,  vertigo,  .stupor,  and 
convulsions. 


DISEASES  OF  ARTERIES. 

The  chief  morbid  conditions  seen  in  arteries  are  :  Wounds,  in- 
flammation, thrombosis,  emboHsm,  degeneration,  and  aneurisms. 
Wounds  belong  essentially  to  surger3^ 

ARTERITIS.      EMBOLISM. 

Internal  and  external  arteritis.  Thrombosis,  from  inflammation.  Em- 
bolism. Bruising.  Stretching.  Ligature.  Lesions.  Extension  of  clot, 
color,  consistency,  adhesion,  lamination.  Composition  of  clot.  Condition 
of  vessel.  Changes  in  muscles.  Causes  :  muscular  tension,  embolism. 
Heart  clots,  venous  clots.  Infecting  debris.  Symptoms  :  paresis  or  par- 
alysis on  exertion.  Local  suffering,  tenderness,  firm  swollen  artery,  de- 
rangement of  nutrition  and  function,  atrophy.  Chronic  arteritis  :  A.ther- 
oma.  Changes  in  serosa.  Fibrous  thickening,  atrophy,  dilatation. 
Strongylus.     Treatment  :  rest,  anodynes,  alkalies,  massage. 

hiflanimatio7i  of  arteries  has  been  divided  into  exte^'nal  and 
internal  arteritis,  according  as  it  affects  the  fibrous  sheath  of  the 
artery  or  its  inner  lining  membrane. 

In  external  arteritis  the  exudation  of  lymph  often  forms  a 
protecting  layer  around  the  vessel,  while  the  inner  coats  continu- 
ing sound  the  current  of  blood  remains  unimpaired.  Even  when 
suppuration  takes  place  in  the  vicinity  of  a  large  artery,  that 
vessel  may  pass  through  the  center  of  the  abscess  and  convey  the 
blood  as  freely  as  before.  The  nutrition  of  the  vessel  thus  de- 
tached from  the  surrounding  tissues  is  maintained  by  its  accom- 
panying nutrient  artery,  though  if  the  akscess  is  large  there  is 
danger  of  a  deficient  supply.  The  frequent  presence  of  .such 
arteries  traversing  an  abscess  should  make  the  surgeon  careful 
how  he  breaks  down  the  bright  pink  bands  occasionally  seen  to 
stretch  across  such  cavities. 

Internal  arteritis,  or  inflammation  of  the  internal  coat  of  an 
artery  is  incomparably  more  serious  and  mainly  because  it  deter- 
mines the  coagulation  of  the  contained  blood  and  consequent 
plugging  of  the  vessel.  This  is  but  one  manifestation  of  the  gen- 
eral law  that  in  inflamed  tissues  the  fibrine  forming  elements  are 
produced  in  excess,  and  when  blood  comes  in  contact  with  these 
it  tends  to  coagulate  (thrombosis).  On  the  other  hand  the  in- 
flammation in  the  arterial  coats  may  ensue  from  the  pressure  of  a 

345 


346  Veterinary  Medicine. 

blood  clot  formed  in  the  veins  or  heart  and  carried  on  with  the 
current  until  it  reaches  an  artery  too  small  to  admit  it  (embolism). 

The  inflammation  may  be  confined  to  a  limited  space  as  when 
an  artery  is  bruised,  stretched  so  as  to  tear  through  its  inner 
coats,  or  interrupted  by  a  ligature.  It  may  on  the  other  hand  be 
diffused  over  a  greater  extent  of  the  vessel,  and  in  some  cases 
two  inflamed  portions  are  separated  by  intervals  of  sound  artery. 

Anatomical  features  of  the  inflamed  artery.  In  active  in- 
flammation of  the  internal  coats  of  an  artery,  it  contains  blood 
clots,  and  if  the  inflamed  surface  is  not  very  limited  in  extent  the 
vessel  is  completely  plugged  and  the  clot  forms  up  to  its  nearest 
transverse  branch  on  the  cardiac  side,  precisely  as  if  the  artery 
had  b2en  tied.  The  resulting  clot  is  sometimes  tubular,  so  that 
an  impaired  circulation  is  still  carried  on.  The  clot  varies  in 
length  according  to  the  extent  of  vessel  inflamed,  or  the  distance 
from  the  inflamed  spot  to  the  nearest  diverging  branch.  The  clot 
is  usually  fusiform  in  outline  and  is  firmly  attached  throughout 
more  or  less  of  its  diameter,  and  occasionally  so  firmly  that  it  is 
all  but  inseparable  from  the  serous  membrane.  The  narro^yed 
ends  of  the  clot  mostly  float  free  in  the  liquid  blood  and  portions 
from  the  end  most  distant  from  the  heart  will  sometimes  get  de- 
tached, and  by  blocking  up  smaller  arteries  give  rise  to  new 
centres  of  disease.  This  is  a  true  instance  of  embolism  or 
plugging. 

The  clot  has  nearly  always  a  grayish  or  yellowish  white  color 
in  the  larger  vessels,  such  as  the  posterior  aorta,  and  an  uniform 
pink  or  red  streaked  with  yellow  in  the  small.  It  is  possei^sed  of 
great  firmness  and  elasticity.  That  portion  of  the  surface  which 
was  not  attached  to  the  arterial  walls,  during  life,  is  clear,  smooth 
and  glistening,  while  the  portion  which  adhered  to  these  walls  is 
rough,  irregular,  and  broken  into  shreds.  It  is  usually  composed 
of  concentric  layers  .showing  its  mode  of  formation. 

Clots  of  this  kind  analyzed  by  M.  M.  Lassaigne  and  Clement 
were  composed  of  water  74  .parts  ;  fibrine  and  albumen  25  parts  ; 
and  alkaline  .salts  i  part. 

The  vessels  filled  by  these  clots  are  very  irregular  in  their  out- 
line being  thick  and  bulging  at  one  point  and  thin  and  constricted 
at  another.  The  outer  coat  is  rarely  the  seat  of  morbid  change, 
though  it  sometimes  shows  branching  redness  and  thickening 
from    exuded    lymph.     The   internal    coat   where   the   clot    was 


Diseases  of  Arteries.  347 

attached  is  intensely  and  unnaturally  red,  and  a  rough  granular 
surface  has  given  place  to  the  healthy,  smooth  glistening  appear- 
ance. In  old  standing  cases  the  clots  can  only  be  separated  from 
such  surfaces  by  dissection  with  the  knife.  Other  portions  of  the 
surface  than  those  to  which  the  clot  adheres  are  usually  smooth 
and  polished,  though  rough  granular  and  injected  patches  are 
sometimes  met  with  independently  of  clots. 

The  mu.scles  formerly  supplied  with  blood  by  the  obstructed 
arteries  are  pale,  discolored,  unnaturally  firm,  and  if  some  time 
has  elapsed  since  the  plugging  their  fibrillated  structure  is  made 
out  with  difficulty. 

Causes.  The  causes  of  arteritis  are  often  obscure.  Goubaux 
conceived  that  it  was  frequently  determined  by  extreme  mu.scular 
tension.  In  support  of  this  view  he  adduced  the  facts  that  it  has 
been  mainly  observed  in  the  horse,  in  which  such  stretching  of 
the  muscles  is  greatest,  and  that  its  most  common  .seats  have  been 
where  the  muscles  and  vessels  are  most  liable  to  stretching. 
Thus  it  is  frequent  in  the  posterior  aorta  towards  its  termination 
or  in  other  words  where  the  adjacent  muscles  (psose)  are  very 
liable  to  laceration  from  slipping  backward  or  from  efforts  to  dis- 
engage the  limbs  when  fixed  in  soft  ground  ;  the  femoral  and 
auxiliary  arteries  are  likewise  frequent  seats  of  inflammation  and 
are  likely  to  be  overstretched  when  the  limbs  slip  outwards. 

Embolism  or  Plugging  of  the  arteries  must  be  accepted  as 
another  cause.  This  is  referred  to  under  endoca7-ditis,  as  an  oc- 
casional consequence  of  the  detachment  of  clots  and  fibrinous 
substances  from  the  internal  membrane  of  the  heart.  The  de- 
tached mass  in  this  case  passes  from  the  heart  into  the  aorta  and 
thence  through  its  divisions  until  it  reaches  a  vessel  too  small 
to  receive  it,  when  it  is  at  once  arrested  and  determines  inflam- 
matorv  action  in  the  plugged  vessel.  When  arrested  in  some 
soft  organ  such  as  the  lungs,  liver  or  brain  the  resulting  inflam- 
mation often  gives  ri.se  to  extensive  suppuration  and  abscess.  In 
other  situations  its  effects  may  be  confined  to  inflammation,  the 
shutting  off,  of  blood  from  particular  parts,  the  impairment  or 
loss  of  their  function  and  nutrition,  and  finally  atrophy  and  de- 
generation. 

But  the  heart  is  not  always  the  primary  .source  of  such  clots. 
Virchow  and  others  have  demon.strated  by  post  mortem  examina- 


348  Veterinary  Medicine. 

tions  in  cases  of  plugging  and  hy  a  number  of  experiments  on  the 
lower  animals,  not  only  that  such  clots  may  have  their  place  of 
nativity  in  some  distant  and  diseased  part  of  the  body  and  pro- 
ceed in  the  veins  to  the  heart,  and  thence  through  the  arteries  to 
other  distant  parts  of  the  body  where  they  plug  the  vessels  and 
induce  a  train  of  mobid  changes  ;  but  that  such  embolism  arteri- 
tis and  abscesses  can  be  produced  at  will  by  the  introduction  into 
the  circulation  of  solid  and  insoluble  (infecting)  bodies.  Frag- 
ments of  decaying  and  suppurating  tissue  and  the  elements  of 
tubercle  and  cancer  may  bs  thus  equally  carried  onward  in  the 
current  of  the  circulation,  and  reproduce  themselves  at  those 
points  where  their  course  is  arrested.  This  is  a  mode  in  which 
secondary  deposits  of  these  morbid  matters  are  determined.  Em- 
bolism and  arteritis  in  the  body  and  limbs  occuring  in  this  way 
necessarily  have  their  point  of  departure  in  pre-existing  disease 
of  the  lungs.  The  clots  loosened  from  the  capillaries  or  veins 
of  the  lungs  are  carried  through  the  left  side  of  the  heart  into  the 
arteries  of  the  body  at  large  to  be  arrested  in  some  of  the  smaller 
vessels.  I  have  seen  plugging  of  the  digital  arteries  of  the  hind 
limbs,  to  occur  in  this  way  in  a  horse  that  had  been  suffering 
from  inflamed  lungs. 

Microbes  and  toxins  may  pass  harmlessly  through  healthy 
parts,  including  the  pulmonic  circulation,  to  establish  colonies 
and  embolism  beyond  where  the  tissues  have  become  debilitated. 
Thus  Gamgee  records  a  case  of  embolism  of  the  anterior  mesen- 
tric,  right  external  iliac  and  right  femoral  arteries,  supervening 
on  an  attack  of  strangles. 

Syinptoms  of  acute  arteritis.  These  consist  largely  in  impaired 
muscular  power  in  the  part,  indications  of  acute  local  suffering, 
such  as  trembling  and  tenderness  to  the  touch,  if  the  obstructed 
vessel  lies  within  reach  it  can  be  felt  as  an  exquisitely  tender  cord- 
like mass,  and  the  limb  on  the  distal  side  of  the  embolism  and 
dependent  on  the  diseased  vessel  for  its  blood  supply  is  anaemic 
and  cold.  In  the  distal  portion  of  the  embolic  artery  and  its 
branches  pulsation  has  ceased.  If  the  lesion  is  extensive  there 
may  be  more  or  less  fever,  but  a  limited  arteritis  in  a  small  vessel 
may  escape  this  complication.  If  the  disease  is  of  long  standing 
there  is  atrophy  of  the  tissues  formerly  supplied  by  the  embolic 
vessels.     The  secondary  derangement  of  nutrition   and  function 


Diseases  of  Arteries.  349 

are  as  varied  as  the  organs  affected  and  will  be  noted  below  in  the 
special  article  on  thrombosis  and  embolism. 

Chronic  arteritis.  Atheroma.  This  is  an  indolent  inflam- 
mation supposed  to  result  mainly  from  strain  and  overwork,  and 
manifested  by  thickening  and  clouding  of  the  serosa,  with  cell 
proliferation,  softening  and  fatty  degeneration.  The  diseased 
substance  becomes  soft,  pultaceous,  slightly  greasy,  and  under 
molecular  degeneration  it  breaks  up  and  is  even  in  part  washed 
on  in  the  blood  stream.  Other  degenerations  may  occur  in  the 
inflamed  walls  of  the  artery.  The  exudate  may  become  organ- 
ized, constituting  fibrous  thickening.  It  may  become  the  seat  of 
calcareous  degeneration.  It  may  yield  to  the  blood  pressure,  be- 
coming slowly  attenuated  (atrophy),  and  even  dilated  (aneurism 
by  dilatation).  As  a  cause  of  chronic  internal  arteritis  in  the 
horse  should  be  named  the  presence  in  the  vessels  of  the  larva  of 
the  strongylus  armatus.  The  posterior  aorta  and  anterior  mesen- 
teric artery  which  are  the  most  commonly  infested  by  these  para- 
sites are  frequently  attenuated,  dilated  and  calcified  in  this  con- 
nection. 

Treatment.  Acute  arteritis  should  be  treated  like  any  other 
local  inflammation,  by  rest,  soothing  applications  (fomentations, 
astringents,  icebags),  and  alkaline  salts.  It  has  been  proposed 
to  manipulate  the  affected  artery  and  contained  thrombus,  but 
this  can  onl}^  tend  to  block  the  smaller  arteries  farther  on,  and 
perhaps  with  even  more  injurious  results.  The  liberal  use  of 
alkalies  on  the  other  hand,  if  effective  in  dissolving  any  portion 
of  the  clot,  returns  this  to  the  blood  stream  in  a  condition  that 
will  not  endanger  further  embolism.  The  agents  usually  em- 
ployed are  carbonates  of  ammonia,  potash  or  soda,  and  iodide  of 
potassium. 


THROMBOSIS    AND  EMBOLISM. 

Definition.  Thrombosis — clotting  in.  the  vessel.  Embolism,  blocking  of 
the  vessel.  Thrombus  may  form  in  any  bloodvessel.  Embolism  occurs  in 
arteries.  Clot  follows  the  blood  current.  Causes  of  clotting — fibrinogen, 
paraglobulin,  fibrine  ferment ;  foreign  bodies  ;  parasites  ;  air  ;  blood  that  has 
been  exposed,  (transfusion;  aerial  germs  ;  disease  germs  ;  chemical  coagu- 
lants; high  and  low  temperatures  ;  I>reaches  of  endothelium  ;  congestion  or 
inflammation  of  the  serosa  ;  stasis  of  blood  and  extensiou  of  clot  ;  ligature 
near  a  branch  vessel  :  deoxidation  and  carbonization  of  blood  ,  marasmus  ; 
neoplasms  ;  traumas  of  the  vascular  coats.  Infarction,  causes  of  blocking  ; 
disintegration  of  clots,  softening,  liquefaction,  ulceration,  action  of  microbes  ; 
excess  of  white  globules  ;  air;  fat;  parasites.  Pathogenesis;  complete  oc- 
clusion of  vessel;  infarction  ;  sequestrum;  colateral  circulation;  embolism 
of  external  iliac  or  femoral  artery  ;  effects  on  pulse  ;  during  rest ;  atrophy  ; 
lameness  comes  on  with  exertion  ;  disappears  underrest  ;  circulation  inade- 
quate to  sustain  active  function.  Embolism  of  internal  iliac  artery;  efi'ect 
on  pulse  ;  on  tail  and  pelvic  organs.  Embolism  of  axillary  artery  ;  effect 
on  pulse,  action,  nutrition.  Embolism  of  mesenteric  artery  ;  verminous  ; 
effects  on  innervation  and  circulation  ;  spasms,  congestions,  paresis  ;  invo- 
lution.    Treatment  :  expectant ;  alkalies  ;  gentle  exercise,  time. 

Definitio)i.  Thrombosis  i.s  the  blocking  of  a  blood  vessel  by 
a  clot  formed  in  its  interior  by  the  deposition  of  layer  above  layer 
on  its  inner  coat. 

Embolism  is  the  blocking  of  a  bloodvessel  by  a  clot  or  other 
solid  body  formed  at  a  distant  point  of  the  circulation  floated  on 
in  the  blood  stream,  and  arrested  when  it  reaches  a  vessel  too 
small  to  transmit  it. 

A  thrombus  may  be  formed  at  any  point  of  the  circulatory  ap- 
paratus (heart,  arteries,  veins)  whenever  the  conditions  are  such 
as  to  determine  coagulation  of  the  blood.  An  embolism  on  the 
contrary  is  a  disea.se  of  the  arteries  since  in  the.se  the  blood  cur- 
rent, proceeding  centrifugally  from  the  greater  to  the  lesser,  inev- 
itably carries  the  moving  solid  to  a  point  too  narrow  to  allow  of  its 
further  progress.  Thus  clots  originating  in  the  .systemic  veins 
or  right  heart  pass  to  the  lungs  atid  produce  embolism  of  the  pul- 
monary arteries  whereas  those  formed  in  the  pulmonary  vein  or 
left  heart  are  arrested  in  some  part  of  the  systemic  arteries.  Clots 
formed  in  the  portal  vein  however  are  arrested  in  the  hepatic  ves- 
sels into  which  that  trunk  breaks  up. 
350 


Thrombosis  and  Embolism.  351 

Causes  of  Thrombus.  The  production  of  a  thrombus  may  be 
due  to  the  condition  of  the  blood  or  of  the  vessels.  The  researches 
of  Buchanan,  Schmidt,  Hammersten  and  others  show  that  two 
albuminoid  elements,  fibrinogen  and  paraglobulin,  present  in  the 
living  blood,  and  a  fibrine  ferment  mainly  derived  from  the  white 
corpuscles  iu  process  of  change  or  destruction,  determine  power- 
fully the  formation  of  fibrine  and  clot.  Hewson,  Briicke  and  Lis- 
ter have  shown  that  blood  may  hz  maintained  fluid  for  many 
hours  iu  an  unimpaired  vein,  or  turtle's  heart  tlicguh  it  may  have 
been  removed  from  the  body,  the  important  condition  bc;ing  that 
the  vein  shall  retain  its  vitality  and  suffer  no  derangement  of  its 
endothelium.  Lister  has  even  shown  that  blood  may  remain 
fluid  for  many  hours  in  a  sterilized  glass  tube  which  has  been 
filled  by  passing  the  tube  carefully  inlo  such  a  vein  without  dis- 
turbing its  lining  membrane,  or  imparting  motion  to  the  liquid.  In 
such  a  case  a  thin  film  of  coagulum  only,  forms  on  the  interior  of  the 
glass  tube.  In  healthy  blood,  without  addition  of  any  extraneous 
matter,  and  kept  perfectly  still,  the  plasma  and  globules  retain 
their  integrity,  and  the  former  its  fluidity  for  a  length  of  time. 
But  if  shed  into  a  basin  it  coagulates  at  once. 

a.  Changes  in  the  blood.  Contact  with  foreign  bodies  generally 
determines  this  change  and  prompt  coagulation.  Transfixing  the 
artery  with  a  needle,  even  a  silver  one,  the  entrance  of  parasites 
(actinomycosis,  strongyli,  filaria),  the  presence  of  pus,  and  of 
certain  infectious  microbes  and  their  products,  the  introduction  of 
solid  particles  i^aid  even  of  air  into  the  vessels,  the  transfusion  of 
blood  which  has  been  exposed  to  receive  aerial  germs,  or  which 
contains  microscopic  clots,  or  the  globules  of  which  have  become 
modified  by  contact  with  a  basin  or  other  vessel,  even  the  trans- 
fusion of  defibrinated  blood  may  cause  coagulation.  The  danger 
is  always  greater  if  the  blood  is  drawn  from  a  different  genus  and 
unfitted  to  live  in  the  blood  of  the  recipient.  Disease  germs  are 
especially  dangerous  if  adapted  to  colonize  the  serosa  of  the  ves- 
sel and  destroy  its  epithelium.  A  decrease  of  the  density  of  the 
blood  favors  coagulation,  a  lowering  of  one  thousandth  rendering 
it  syrupy,  and  various  chemical  agents  induce  or  favor  coagulation, 
thus  acetic  acid,  valerianic  acid,  alcohol,  the  salts  of  iron,  and 
above  all  the  salts  of  lime  act  in  this  way.  Very  high  and  low 
temperatures  throw  down  the  fibrine  as  a  grumous  precipitate,  but 
the  clot  remains  soft. 


352  Veterinary  Medicine. 

b.  Changes  i7i  the  vessels.  Any  disturbance  or  alteration  of  the 
endothelium  sets  free  the  so-called  fibrine  ferment,  and  precipi- 
tates coagulation.  Lister  found  that  contact  of  ammonia  with 
the  interior  of  an  otherwise  living  vein  caused  a  thrombus.  So  in 
all  endarteritis  and  phlebitis  coagulation  takes  place  on  the  serosa 
and  quickly  blocks  the  vessel.  Even  in  the  capillary  vessels  the 
same  principle  holds,  and  in  inflammation  minute  coagula 
(thrombi)  form  in  the  capillary  network  throughout  the  whole 
inflamed  area.  This  explains  not  only  the  capillary  blood  stasis 
but  the  thrombosis  of  inflamed  arteries  and  veins.  In  these  two 
latter  the  clot  increases  and  extends  in  the  direction  of  blood 
stasis  : — in  the  artery  toward  the  heart  as  far  as  the  next  colateral 
branch,  and  in  the  veins  away  from  the  heart  as  far  as  to  the  next 
colateral  trunk.  On  the  distal  side  of  the  arterial  thrombus  the 
blood  flows  off  freely  toward  the  capillaries,  but  on  the  proximal 
or  cardiac  side  it  is  absolutely  stagnant  up  to  the  next  branch 
through  which  it  can  freely  flow  into  the  capillary  plexus.  Into 
this  stagnant  blood  the  fibrine  ferment,  produced  by  the  altered 
white  globules  in  the  clot  already  formed,  slowly  extends  until 
the  whole  has  formed  a  firm  coagulum.  Beyond  this  the  actively 
moving  blood  carries  off  and  dilutes  this  ferment  so  rapidly  that 
it  can  exert  no  appreciable  effect  on  the  fibrine-forming  elements. 
The  principle  is  an  important  one  in  surgery,  as  the  clot  formed 
entad  of  the  ligature  will  be  extensive  in  proportion  to  the  dis- 
tance from  the  first  colateral  trunk,  and  in  inverse  proportion  to 
this  clot  will  be  the  danger  of  secondary  haemorrhage.  In  veins 
the  same  rule  holds,  with  this  difference  that  as  the  blood  is  flow- 
ing toward  the  heart  it  empties  the  vessel  on  the  cardiac  side,  and 
stagnates  on  the  distal  side  up  to  the  next  colateral  branch. 
Hence  it  is  that  a  thrombus  in  a  vein  always  extends  away  from 
the  heart,  while  that  of  the  artery  extends  toward  it. 

Another  cause  of  coagulation  is  the  deoxidation  of  the  blood 
and  the  excess  of  carbon  dioxide.  This  occurs  in  the  .stagnant 
blood  in  the  vessels  and  above  all  in  the  capillaries.  The  normal 
trophic  changes  in  the  serosa,  fail  to  take  place  in  contact  with 
blood  in  this  .state,  and  the  resulting  changes  in  the  white  and 
endothelial  cells  set  free  fibrine  ferment  and  determine  coagula- 
tion. Stasis  of  the  blood  from  any  cause  (ligature,  pressure,  em- 
bolism), tends  to  this  condition  and  the  extension  of  the  coagulum. 


Thrombosis  and  Embolism.  353 

A  thrombosis  of  marasmus  has  been  observed  in  anaemic  and 
debilitating  diseases,  and  apart  from  the  microbian  invasions  in  a 
certain  number  of  those  affections,  this  may  be  looked  on  as  due 
in  part  to  the  lessened  density  and  other  changes  in  the  blood  and 
to  the  debility  of  the  serosa  of  the  vessels. 

The  compression  of  the  vascular  walls  or  their  penetration  by 
neoplasms,  tumors  and  ulcers,  is  another  cause  of  coagulation  and 
thrombus,  also  a  varicose  or  aneurismal  dilatation,  with  weaken- 
ing of  the  vascular  walls,  or  dilatation  of  the  heart  with  structural 
changes  in  the  endocardium  as  stated  under  that  heading,  or 
compression  of  the  smaller  vessels  and  capillaries  by  an  exudate 
in  process  of  organization,  or  a  similar  obliteration  under  the  ac- 
tion of  extreme  cold.  Injury  to  the  serosa  of  the  vessel  by 
stretching,  bruising,  laceration  or  section  determines  a  thrombus 
starting  from  the  injured  endothelium.  In  the  smaller  vessels 
the  thrombus  is  usuall}^  deep  red  from  the  entangling  of  a  large 
quantity  of  red  globules,  whilst  in  the  larger  arteries  the  greater 
part  of  the  globules  pass  on  and  the  coagulum  is  largely  buff  or 
straw  colored. 

Again  in  obstruction  in  the  smaller  arteries,  the  inactive  capil- 
lary plexus  and  the  tissue  beyond  are  liable  to  become  gorged  with 
blood  with  excess  of  red  globules,  from  the  adjacent  capillary  net- 
work, constituting  infarction,  and  ending  in  gangrene.  In  cases 
in  which  this  is  prevented  by  the  action  of  intense  cold  the  part 
may  remain  pale,  as  white  infaj'dion. 

Causes  of  Embolism.  As  already  stated  embolism  results  from 
a  detached  portion  of  a  thrombus  passing  to  a  smaller  vessel  and 
obstructing  it.  Such  detachment  is  favored  b}^  molecular  softening, 
liquefaction  or  suppuration  in  the  clot  or  beneath  it,  by  the  de- 
structive action  of  microbes,  or  by  friction  or  manipulation  of  the 
ob.structed  vessel.  Excess  of  white  globules  (leukaemia)  favors 
the  formation  of  minute  coagula  and  embolism.  Bubbles  of  air, 
globules  of  fat,  or  cholesterine  crystals  block  the  fine  pulmonary 
capillaries,  and  the  debris  from  atheromatous  patches,  ulcers,  and 
tumors  opening  on  the  inner  wall  of  the  artery  form  emboli  in 
various  parts.  Finally  parasites,  especially  the  larval  strongydi 
in  solipedes  and  filaria  and  spiroptera  in  dogs,  themselves  obstruct 
the  vessels  and  determine  coagulation. 

Pathogenesis.  In  the  larger  arteries  (aorta,  radical  stump  of 
23 


354  Veterinary  Medicine. 

the  mesenteric  artery)  clots  (as  from  strongles)  rarely  produce 
dangerous  obstruction.  In  the  smaller  vessels  stenosis  is  com- 
plete and  anaemia  and  gangrene  are  liable  to  occur  unless  the  blood 
supply  is  partially  maintained  by  anastomotic  vessels.  When  the 
embolism  affects  a  number  of  smaller  arteries  or  capillaries  in  a 
va.scular  organ  like  the  lungs,  the  blood  filters  in  from  the  adja- 
cent capillaries,  in  which  circulation  is  still  carried  on,  and  this 
passes  through  the  softened  and  ruptured  capillary  walls  so  that 
the  tissue  is  charged  with  globules  and  constitutes  a  black  infarc- 
tio?t.  In  the  lung  this  usually  affects  one  or  several  lobulettes, 
forming  a  pear  shaped  mass  corresponding  to  the  distribution  of 
the  obstructed  vessel.  The  cut  surface  is  black,  compact  and 
granular.  The  lymph  thrown  out  around  it  forms  an  organized 
fibrous  sac,  and  the  unclosed  sequestrum  undergoes  a  slow  necro- 
biosis, blanching  and  liquefaction  into  a  pus-like  fluid  which  is 
removed  by  absorption.  Such  results  are  met  with  in  the  paren- 
chymatous organs  (lungs,  liver,  spleen,  kidneys,  etc.)  and  less 
frequently  in  the  limbs.  The  symptoms  will  correspond  to  the 
particular  organ  invaded. 

In  the  fore  or  hind  limbs  the  result  is  usually  less  radical.  The 
vessels  below  the  obstructed  trunk  are  connected  more  or  less 
freely  by  anastomosing  branches,  so  that  the  circulation  in  the 
tissues  below,  though  somewhat  restricted,  remains  active  enough 
to  sustain  a  fair  measure  of  nutrition.  Apart  from  the  suffering, 
attendant  on  the  preliminary  inflammation,  the  morbid  phenomena 
are  largely  confined  to  the  absence  of  pulsation  in  the  lower  part 
of  the  limb  and  the  inability  of  the  muscles  to  sustain  active  con- 
traction. 

Chronic  Embolism  of  the  External  Iliac  or  Femoral  Ar- 
tery. In  this  condition  the  pulsations  in  the  digital  arteries  are 
imperceptible,  if  it  has  been  of  long  standing  there  may  be  obvious 
atrophy  of  the  muscles  of  the  thigh,  but  when  standing  quietly  or 
walking  there  is  usually  no  lameness.  In  continuous  rapid  walk- 
ing and  above  all  in  the  trot,  however,  he  soon  begins  to  halt  on 
the  affected  limb,  and  this  rapidly  increases,  the  joints  bending 
under  his  weight,  the  toe  dragging  and  the  animal  threatening  to 
drop  altogether.  If  stopped  and  allowed  to  rest  for  ten  or  fifteen 
minutes  he  gradually  recovers  and  may  be  led  quietly  back  to  his 
stable  without  a  .sign  of  lameness.  But  if  again  trotted  fifty  or 
one  hundred  paces  the  lameness  develops  anew  and  disapppears  in 


Thrombosis  and  Embolism.  355 

the  same  way  when  left  at  rest.  The  circulation  in  the  muscles 
is  enough  for  a  moderate  nutrition  but  altogether  inadequate  to 
sustain  active  work. 

Chronic  Embolism  of  the  Internal  Iliac  Artery.  Inthisca,se 
the  control  of  the  muscles  of  the  limb  may  be  perfect  but  there  is 
some  indication  of  paresis  of  tail,  bladder,  rectum  and  anus.  Im- 
paction of  the  rectum  is  liable  to  occur.  By  examination  through 
the  rectum  the  pulsations  are  felt  to  be  strong  in  the  aorta  and  ex- 
ternal iliac,  but  imperceptible  in  the  internal  iliac  blocked  by  the 
embolus. 

Chronic  Embolism  of  the  Axillary  Artery.  Here  there  are 
the  same  general  symptoms,  the  absence  of  the  radial  and  digital 
pulsations,  the  wasting  of  the  muscles  of  the  forearm,  and  the 
intermittent  lameness,  developed  rapidly  by  exercise  and  recover- 
ing promptly  under  rest. 

Acute  Embolism  of  the  Mesenteric  Arteries.  This  will  be 
fully  treated  under  the  title  of  verminous  colic  in  solipedes.  The 
blocking  of  the  branches,  usually  of  the  anterior  mesenteric 
artery,  leads  to  derangement  of  the  innervation,  congestions, 
spasms,  involutions  and  other  disorders.  The  presence  of  the 
strongyli  in  the  fgeces,  the  general  symptoms  of  intestinal  worms, 
and  the  recurrence  of  the  indigestions  and  spasms  would  .serve  to 
indicate  the  nature  of  the  complaint. 

Treah7ient  of  Chronic  Embolism .  As  affecting  the  arteries  of  the 
limbs  the  repair  must  be  largely  left  to  nature,  and  we  must  place 
the  patient  in  condition,  favorable  to  such  repair.  Except  in  the 
early  stages  absolute  rest  is  not  necessary.  Gentle  exercise  stim- 
ulating to  a  freer  circulatoin  solicits  a  slow  enlargement  o£  the 
anastomosing  vessels  (arterial  or  capillar)^),  and  when  this  has 
reached  a  given  stage,  weak  pulsations  may  again  be  felt  in  the 
vessels  beyond  and  the  muscles  will  once  more  stand  moderate, 
work  without  lameness.  Alkalies  and  iodide  of  potassium  may 
be  given  to  solicit  solution  of  the  clot,  but  this  can  rarely  be 
counted  on  to  the  extent  of  rendering  the  vessel  once  more  per- 
vious. A  small  paddock  in  which  the  patient  can  move  around 
quietly  is  desirable,  and  in  a  few  months  a  tolerable  recovery  may 
have  taken  place. 

Embolism  in  other  organs  must  be  treated  on  the  same  general 
expectant  method,  and  a  considerable  time  is  usually  necessary  to 
secure  a  fair  recovery. 


ANEURISM. 

Definition.  Divisions,  true,  false,  dissecting,  arterio-venous,  mixed, 
traumatic,  spontaneous.  Causes,  violence,  rupture,  debilitated  vascular 
walls,  strains,  stretching,  force  of  blood  current,  overloaded  intestine,  strou- 
gyli,  contiguous  inflammation,  embolism,  microbian  invasion  of  the  walls, 
arteritis,  concussion.  Symptoms,  soft  tumor  pulsating  with  the  heart,  a 
double  rushing  sound,  diagnosis  from  abscess,  nervous  disorders  through 
pressure,  cramps,  palpitations.  Treatment,  when  desirable,  rest,  moderate, 
laxative  diet,  iodides,  bromides,  icebags,  compression,  ligature,  galvano- 
puncture,  wire  coils,  injections. 

Definition.  A  pulsating  swelling  on  an  artery,  consisting  of  a 
sac  filled  with  arterial  blood. 

Divisions.  A  true  aneurism  (aneurism  by  dilatation,  ar- 
teriectasis)  is  a  simple  dilatation  of  the  artery,  the  tumor  being 
surrounded  on  all  sides  by  the  distended  arterial  walls.  It  is 
usually  fusiform  or  cylindroid,  but  may  have  the  form  of  a  more 
or  less  rounded  sac. 

A  false  aneurism  is  where  the  wall  of  the  artery  has  been 
lacerated  and  the  blood  is  enclosed  in  an  adjacent  sac  of  con- 
densed connective  tissue  and  communicates  •  with  the  interior  of 
the  vessel.  The  same  name  has  been  given  to  cases  in  which  the 
inner  coat  only  has  given  way,  and  the  middle  and  outer  coats 
constitute  the  walls  of  the  sac.  From  its  liability  to  extend  and 
separate  the  tissues  this  is  further  known  as  a  dissecting  aneur- 
ism. Arterio-venous  aneurism  in  which  an  intervening  sac 
communicates  with  both  artery  and  vein,  has  been  found  in  the 
human  subject. 

Mixed  aneurisms  are  those  in  which  a  dilatation  of  the  artery 
is  complicated  by  the  presence  of  an  outside  pouch. 

A  distinction  has  also  been  made  according  to  origin  into 
traumatic  and  spontaneous.  The  former  is  of  necessity  false, 
whereas  the  latter  may  be  false  or  trjie. 

Causes.  Apart  from  rupture  of  the  arterial  coat  by  direct  vio- 
lence, the  common  cause  is  a  debility  and  loss  of  resistance  in  the 
walls.  In  horses  a  far  larger  proportion  of  aneurisms  are  deep- 
seated  than  in  man,  in  whom  forced  muscular  effort  is  less  com- 
mon. Yet  even  in  horses  the  most  common  seat — the  posterior 
aorta — is  liable  to  overstretching  and  to  inflammation  and  soften- 
ing by  reason  of  contiguity  to  dorsal  sprains.  The  posterior 
356 


Aneurism.  357 

aorta  too,  from  its  size  and  direction  on  leaving  the  heart,  is  in 
the  direct  Hne  of  the  strongest  blood  current,  and  under  long  con- 
tinued, forced  and  violent  efforts  (as  in  racing,  hunting,  and 
heavy  uphill  draughts),  has  to  sustain  an  extraordinary  blood 
pressure.  Bouley  claims  as  an  additional  cause  the  pressure  of  a 
loaded  colon.  This  is  also  the  point  of  all  others  where  the  ves- 
sels suffer  from  the  presence  of  the  larval  strongyli.  From  what- 
ever cause  originating,  congestion  of  the  arterial  coats  leads  to 
more  or  less  attenuation,  softening  or  lack  of  cohesion,  and  they 
tend  to  yield  under  the  blood  pressure.  Similar  conditions  op- 
erate on  the  smaller  vessels  in  different  parts  of  the  body,  and 
thus  overstretching,  contiguous  inflammation,  and  excessive 
blood  pressure  cause  such  lesions  in  the  chest,  trunk  and  limbs. 

Another  cause  is  embolism  which  by  blocking  an  arterj^  at  once 
increases  the  tension  in  the  vessel  on  the  cardiac  side  of  the  ob- 
struction, and  develops  inflammation  in  the  arterial  coats,  robbing 
them  of  their  cohesion  and  resisting  power. 

Eppinger  has  shown  the  importance  of  infectious  microbes  in 
weakening  the  arterial  walls  and  predisposing  to  aneurism. 

The  larval  strongylus  armatus  already  referred  to  is  the  most 
potent  factor  in  solipedes.  They  accumulate  in  the  anterior 
mesenteric  artery,  leading  to  clotting  of  the  blood,  inflammation  of 
the  serous  coat,  and  dilatation,  so  that  in  some  verminous  locali- 
ties nearly  every  old  horse  shows  a  lesion  of  this  vessel. 

All  forms  of  arteritis,  and  disease  of  the  vascular  walls  which 
entail  attenuation  or  weakening,  predispose  to  aneurism. 

Of  direct  traumatism  may  be  mentioned  an  aneurism  of  the 
arch  of  the  aorta  in  a  horse  struck  b}^  a  wagon  pole,  during  a  sharp 
descent  (Jacob),  and  two  with  aortic  aneurism  after  violent  blows 
on  the  back  with  shafts  of  wagons. 

Symptoms.  An  aneurism  within  reach  of  the  hand  is  to  be 
recognized  primarily  by  the  pulsation  of  tlie  swelling  synchron- 
ously with  the  beats  of  the  heart,  and  by  a  double  rushing  sound 
with  each  beat  of  the  heart,  observed  on  auscultation.  An  ab- 
scess over  a  large  artery  lying  on  a  bone  may  puLsate  but  it  is  to 
be  distinguished  b)^  the  presence  of  a  single  in  place  of  a  double 
rushing  sound  on  au.scultation,  by  the  possibility  of  causing  more 
or  less  complete  collapse  under  pressure,  and  by  the  history  of  an 
active  phlegmonous  inflammation  followed  by  softening  which 
steadih^  extends  from  the  centre  of  the  previously   dense  mass. 


358  Veterinary  Medicine. 

In  a  case  of  aneurism  of  the  gluteal  artery  of  the  horse  reported  by 
King  and  in  one  observed  by  the  author  the  symptoms  were  unmis- 
takable. Other  similar  examples  on  the  popliteal  artery  and  other 
failed  to  be  recognized  during  life  though  attended   by  lameness. 

In  internal  aneurism  the  symptoms  are  mostly  indefinite.  Olli- 
vier  found  tympany  and  vomiting  in  a  goat  which  at  the  necropsy 
showed  an  aneurism  of  the  anterior  aorta  as  large  as  the  closed 
fist  and  enclosing  a  sewing  needle.  A  more  careful  diagnosis 
should  have  detected  a  retarding  of  the  maxillary  pulse  and  a 
double  rush  over  the  carotid  with  each  beat  of  the  heart.  Pres- 
sure on  the  vagus  doubtless  led  to  the  symptoms  noticed.  In 
aneurism  of  the  posterior  aorta  there  have  been  noticed  a  loss  of 
life  and  energy,  dulness,  lack  of  appetite  and  stiffness  of  the  loins. 
Torpor  of  the  bowels,  expulsion  of  faeces  with  effort  and  groaning, 
intermittent  colics,  lameness  in  one  or  both  hind  limbs,  and  finally 
cramps  in  the  hind  limbs,  and  palpitations.  In  one  case  Maillet 
was  able  to  reach  the  aneurismal  tumor  through  the  rectum. 

Treatment.  The  treatment  of  internal  aneurism  will  be  seldom 
called  for  in  the  lower  animals,  as  the  disease  is  seldom  diagnosed, 
is  beyond  reach  of  mechanical  applications,  and  survival  without 
certain  power  of  endurance  would  seldom  be  desirable.  In  some 
valuable  breeding  animals  it  might  be  worth  while  to  seek  pro- 
longation of  life.  The  most  promising  measures  are  absolute 
rest,  and  low,  non-stimulating  diet  of  a  laxative  nature  and  in 
small  bulk.  Iodide  of  potassium  is  often  useful  in  man,  and  al- 
though in  the  lower  animals  there  is  not  the  excuse  of  specific 
disease,  yet  the  rest  to  the  circulation  and  reduction  of  blood  ten- 
sion are  not  to  be  undervalued.  Bromides  may  be  given  with  the 
same  object. 

Other  measures  applicable  only  to  aneurisms,  within  reach  and 
essentially  of  a  surgical  nature  include  :  Ice  bags  and  com- 
pression. The  compression  should  as  a  rule  begin  at  the  distal 
end  of  the  limb  and  be  concentrated  by  suitably  shaped  pads  on 
the  swellings.  Ligature  of  the  diseased  artery  above  or  below  or 
both  above  and  below  the  tumor.  Galvano-puncture  of  the  aneu- 
rism with  the  object  of  inducing  coagulation.  The  introduc- 
tion of  coils  of  fine  wire  through  a  hypodermic  needle  with  the 
same  object  in  view.  In  both  horse  and  dog  the  persistent  com- 
pression with  the  finger  seconded  as  it  is  by  the  plasticity  of  the 
blood  has  succeeded  in  checking   the    flow   from  large  arterial 


A  i'te7-io- Sclerosis.  359 

orifices,  and  offers  great  encouragement  in  the  application  of 
this  measure  to  aneurisms.  The  injection  into  the  sac  of  tincture 
of  chloride  of  iron  with  firm  compression  to  prevent  motion  of  the 
blood   is  another  available  resort. 


ARTERIO-SCI.EROSIS. 

Fibrous  thickening  of  the  arterial  coats  and  calcification  are 
well  known  lesions  in  the  posterior  aorta  particularly  of  the  horse. 
Commencing  in  congestion  or  degeneration  which  lessens  the  re- 
sistance of  the  vascular  walls,  the  condition  tends  to  dilatation,  and 
if  this  is  checked  by  compensatory  thickening,  the  condition  of 
.sclerosis  is  induced.  The  combination  of  a  slight  fusiform  dilata- 
tion and  fibrous  or  calcareous  sclerosis  is  well  known  in  the  pos- 
terior aorta  of  the  horse.  Unless  it  advances  to  marked  aneuris- 
mal  dilatation  the  condition  is  not  often  recognized.  If  diagnosed, 
rest  and  quieting  of  the  circulation  are  especiall}^  indicated. 
Should  it  occur  in  other  parts  of  the  body  the  symptoms  would  cor- 
respond to  the  organ  invaded. 


AXGEIOMA.      CIRCOID     ANEURISM.      ANEURISM    BY 
ANASTOMOSIS.     VENOUS  TUMOR.     NCEVUS. 

These  are  forms  of  dilatation  and  elongation  of  the  network  of 
small  arteries,  or  veins,  and  even  of  the  intervening  capillaries. 
In  man  these  constitute  the  unsightly  red  patches  and  swellings 
that  appear  on  the  face  and  hands.  In  animals  with  dark  skins 
a-id  hairy  covering  they  can  only  be  recognized  by  the  .swelling, 
the  feeling  as  of  a  bag  of  worms  when  the  hand  is  pa.ssed  over  it, 
and  by  the  rushing  sound  when  auscultated.  The  trouble  is  us- 
ually .subcutaneous  and  is  essentially  a  surgical  one.  The  most 
promising  treatment  is  by  persistent  pressure,  by  electric  current 
supplementing  the  pres.sure,  by  electro-puncture,  and  by  injec- 
tions of  muriate  of  iron.  When  the  noevus  is  not  too  extensive 
a  double  thread  drawn  by  a  needle  through  beneath  the  tumor  at 
.short  intervals,  then  cut  and  each  point  tied  separatelj^  so  as  to 
completely  stop  circulation  is  most  effective. 


PHLEBITIS. 

Divisions,  traumatic  and  idiopathic.  Causes,  punctures,  defective  blood 
supply  in  walls,  debile  coats,  thrombus,  infection,  overstretching,  injury  or 
disease  of  serosa,  irritants  in  blood,  microbic  infection.  Lesions,  exuda- 
tion, cell  growth,  breaches  in  serosa.  Adhesive  phlebitis,  desquaniaiion, 
granulation,  occlusion.  Suppurative  phlebitis,  infection,  pyaemia,  erysip- 
elas, metritis,  ulceration,  neoplasms,  phlebolites.  Symptoms,  local,  firm, 
corded,  swollen  vein,  extends  entad,  venous  congestion,  dropsy,  gangrene, 
diagnosis  from  lymphangitis.  Fever,  venous  congestion  in  vicinity. 
Treatment,  germicide,  rest,  cold,  antiseptics,  blisters. 

Inflammation  of  veins  as  seen  in  the  lower  animals  has  usually 
been  a  sequel  of  bleeding  and  is  hence  a  purely  surgical  lesion. 
Animals  as  well  as  man  however  are  subject  to  idiopathic  phlebi- 
tis which  as  affecting  the  deeper  seated  veins  may  be  held  to  be  a 
medical  subject. 

The  causes  of  idiopathic  phlebitis  are  varied.  Injury  to  the 
walls  like  the  punctures  made  in  bleeding;  if  they  result  in  the  ex- 
posure of  a  raw,  and  above  all  an  inflamed,  surface  to  the  blood, 
tends  to  the  formation  of  a  thrombus,  and  of  local  inflammation. 
Even  the  inflammation  of  the  outer  coat  tends  in  the  same  way 
to  thrombosis  and  phlebitis,  and  the  experiment  of  Nicas.se 
showed  that  the  dissection  of  its  sheath  from  a  vein,  thus  robbing 
it  of  its  vascular  and  nervous  supply  promptly  induced  coagula- 
tion of  the  blood  in  the  denuded  part.  The  debilitated  or  devi- 
talized walls  evidently  give  off  fibrinogen  and  fibrine  ferment  in 
amount  that  is  incompatible  with  the  maintenance  of  fluidity.  All 
other  forms  of  direct  injury  to  the  veins,  leading  to  disturbance 
of  the  endothelium  or  cell  enlargement  or  exudation  intheintima, 
will  operate  in  the  same  manner.  Sometimes  as  in  puerperal 
phlebitis  the  inflammatiou  extending  from  the  adjacent  tissue  to 
the  walls  of  the  veins,  determines  thrombosis,  and  the  invasion  by 
pus  microbes  determines  suppuration.  Bruises,  over-.stretching, 
pressure  with  over-distension,  and  the  circulation  in  the  blood  of 
irritant  matters  may  lead  to  changes  in  the  wall,  thrombus,  and 
inflammation.  Such  irritants  may  be  septic  or  other  bacterial 
products,  or  they  may  arise  from  the  colonization  of  bacteria  on  or 
in  the  venous  coats  with  the  same  final  result. 
360 


Phlebitis.  361 

The  lesiojis  in  the  vein  are  often  primarily  of  the  nature  of  exu- 
dation and  cell  growth  in  the  coat,  without  at  first  any  change  in 
the  serosa  or  endothelium.  L,ater  the  changes  implicate  those, 
thrombosis  follows  and  one  of  various  ulterior  processes. 

In  adhesive  phlebitis  which  is  most  frequent  as  the  result  of 
purely  mechanical  injury,  the  endothelium  is  disquamated  and 
granulations  from  the  denuded  surface  extend  into  the  clot  and  fi- 
nally occlude  the  vein.  A  recovery  takes  place  by  the  organiza- 
tion of  this  new  product  and  the  contraction  of  the  vessel  into  a 
simple  fibrous  cord. 

In  suppurative  phlebitis,  which  occurs  especially  in  connec- 
tion with  infection  (erysipelas,  metritis),  the  inflammation, 
though  starting  in  the  same  way  in  the  vascular  coats,  advances 
rapidly  to  suppuration,  and  the  intima,  lying  in  contact  with  the 
resulting  thrombus  may  become  itself  the  seat  of  the  suppurating 
process.  Cases  of  this  kind  are  almost  of  necessity  in  the  nature 
of  an  infection  and  the  danger  is  greatly  enhanced.  Small  ab- 
scesses formed  in  the  vascular  coats  may  burst  into  the  vein  and 
passing  on  with  the  blood  produce  general  infection  (pyaemia). 
Even  when  the  pus  enters  the  vein  at  a  point  covered  by  the 
thrombus,  it  may  escape  by  the  partial  loosening  of  the  clot  from 
the  serosa,  or  through  the  interior  of  a  honey-combed  coagulum 
and  thus  lead  to  general  infection.  This  is  especially  liable  to 
follow  in  erysipelas  and  metritis,  in  which  the  tendency  as  in  the 
solid  tissues  is  to  diffuse  suppuration  without  any  investing  limit- 
ing membrane.  There  are  other  forms  of  bacterial  colonization 
of  the  vascular  walls,  of  ulceration,  and  of  the  extension  of  mor- 
bid growths  into  or  through  the  venous  walls,  producing  inflam- 
mation niDre  or  less  localized,  and  leading  or  not  to  general 
infection.  The  presence  of  phlebolites  in  the  vein  is  a  conceiva- 
ble source  of  phlebitis,  though  no  such  case  has  been  so  far 
recorded. 

The  sympto7ns  in  localized  cas;s  of  simple  adhesive  phlebitis 
may  be  purely  local.  The  vein  if  within  reach  may  be  felt  like 
a  firm,  rounded  cord,  which  extends  in  a  direction  from  the  heart. 
If  there  are  no  free  anastomosis  with  neighboring  veins  on  the 
distal  side  of  the  thrombus,  venous  congestion  and  dropsy  of  the 
tissues  ensue,  and  in  some  cases  moist  gangrene.  When,  how- 
ever,  such  anastomosis  is  abundant  these  peripheral  symptoms 


362  Vetci'inary  Medicine. 

may  bs  absent,  especiall}^  if  the  affected  vein  returns  blood  from 
a  higher  level  than  the  heart,  and  then  the  symptoms  are  confined 
to  the  vein  and  its  immediate  surroundings.  From  lymphangitis 
which  shows  similar  hard  cords,  it  is  distinguished  by  the  absence 
of  an  extended  network  of  diseased  vessels,  by  the  lack  of  a 
diffuse,  doughy  swelling,  and  by  the  fact  that  the  adjacent  lymph 
glands  remain  free  from  inflammation,  pain  and  swelling.  In  the 
more  extended  cases  there  is  fever,  which  may  be  of  a  very  high 
type  and  may  merge  into  pyaemia.  In  deep-seated  cases  it  may 
be  difficult  to  identify  the  disease,  but  it  may  be  suspected  if  in 
the  course  of  erysipelas  or  metritis  there  is  a  sudden  increase  of 
fever  with  pain  and  swelling,  and  distension  of  veins  leading  into 
the  part. 

The  treatment  of  idiopathic  phlebitis  is  largely  that  of  the  par- 
ticular infecting  disease  on  which  it  depends.  In  simple  cases 
due  to  trauma  absolute  rest  and  the  application  of  ice  and  anti- 
septic solutions,  or  where  these  cannot  be  applied,  the  u,se  of  anti- 
septics internally,  will  be  indicated.  Hyposulphite  of  soda  and 
sulphide  of  calcium  are  especially  indicated.  From  the  early  days 
of  veterinary  medicine,  flying  blisters  of  Spanish  flies,  over  the 
inflamed  vein  or  veins  have  proved  very  successful,  and  under 
the  lead  of  Nonat  the  .same  was  in  1858  and  .since  adopted  with 
gratifying  .success  in  the  human  subject.  Abscesses  formed  in 
accessible  .situations  should  be  promptly  opened  and  treated  anti- 
septically,  and  swelling  of  the  affected  part  should  be  checked  by 
elevated  position,  or  if  that  is  impossible,  by  a  smoothly  applied 
bandage.  Rubbing  and  active  movement  are  dangerous,  as  tend- 
ing to  detach  clots  which  float  off  to  start  new  emboli  and  inflam- 
mations in  the  lungs. 


VARICOSE   VEINS.      DILATED    VEINS   WITH 
ALTERED  WALLS. 

Rare  in  animals.  Angioma  Varix.  Superficial.  Deep.  Causes,  ob- 
structed circulation,  compression,  congestion.  Symptoms,  enlargement, 
elongation,  tortuosity  of  veins,  stiffness,  lameness,  complications.  Treat- 
ment, compression,  coagulants,  cauterization,  ligature. 

Varix  is  not  so  common  in  the  lower  animals  as  in  man,  and  is 
generally  observed  in  the  superficial  veins,  so  that  it  comes  under 
the  domain  of  surgery.  In  the  form  of  angioma,  which  affects 
the  veins,  there  is  extensive  dilatation  and  elongation,  but  it  in- 
volves a  large  group  of  connecting  and  anastomosing  veins, 
whereas  varix  usually  affects  but  one  or  a  few  connecting  vessels. 
In  the  horse  the  most  common  seat  of  varix  is  in  the  saphena 
vein,  as  it  passes  obliquely  over  the  inner  side  of  the  hock.  Less 
frequently  it  appears  on  the  flank  or  other  superficial  part.  In 
cattle  the  mammary  veins  are  the  most  frequent  seat.  Varices, 
however,  occur  also  in  deep-seated  veins  and  in  connection  with 
normal  venous  plexuses,  as  in  the  buccal,  palatal,  and  peneal. 
Anatomically  they  may  be  simple  fusiform  dilatations,  as  in  the 
saphena  ;  dilated,  elongated  and  tortuous,  branching  trunks,  as 
in  the  mammary  veins  ;  or  dilated  veins  with  thickened  walls  and 
pouch  like  dilatations. 

Caiises.  There  is  usually  some  obstruction  to  the  circulation 
through  the  affected  vessel,  it  may  be  by  pressure  by  a  tumor,  or 
a  constrained  position,  obliteration  by  a  phlebitis  and  thrombus, 
extension  of  inflammation  from  adjacent  organs,  increased  blood 
pressure  by  gravitation,  or  from  diseased  heart  or  lungs. 
Whether  from  the  extension  of  contiguous  inflammation,  from 
external  pressure,  or  from  blood  tension,  the  morbid  process  has 
much  in  common  ;  the  circulation  and  nutrition  in  the  vascular 
walls  are  interfered  with,  degenerations  set  in  (softening,  fatty, 
connective  ti.ssue),  which  predispose  to  dilatation  under  the  blood 
pressure.  The  pouch-like  dilatations  of  the  jugular  consequent 
on  bleeding,  are  essentially  traumatic.  The  impaired  innervation 
which  lessens  the  resistance  of  the  vascular  walls  is  not  to  be  for- 
gotten.    Varix  of  the  saphena  is  usually  an  attendant  or  sequel 

363 


364  Veterinary  Medicine. 

of  tibio-tarsal  synovitis,  and  is  the  result  of  combined  pressure 
and  congestion.  Mammary  varices  are  manifestly  connected 
with  the  coagestion  and  exudations  which  affect  the  udder  and 
environment  at  the  time  of  parturition,  or  with  a  casual 
niammitis. 

The  symptoms  in  superficial  vessels  are  visible  enlargement, 
and  often  elongation  and  tortuous  direction  of  the  vein  or  veins, 
with  or  without  tenderness.  Deep-seated  varicosities  may  be 
attended  by  stiffness  of  the  part  and  a  halting  in  progression 
with  or  without  pain  on  pressure.  These  cases  may  recover 
spontaneously  as  the  result  of  adhesive  phlebitis,  or  they  may 
develop  phlebolites,  suppuration,  inflammation,  ulceration  and 
haemorrhage. 

Treatment.  Superficial  varices  have  been  treated  by  compres- 
sion, cauterization,  coagulating  injections,  and  ligature.  It 
is  not  often  that  interference  is  demanded  but  in  such  cases, 
pressure  with  elastic  bandage  having  failed,  ligature  with  antisep- 
tic precautions  is  indicated. 


PHIvEBOIvITES.     CALCAREOUS  BODIES  IN  THE  VEINS. 

Nature.  Location.  Mode  of  formation.  Calcareous  plates  in  two  inner 
coats.     Phlebotomy.     Altered  sanguification.     Treatment.     Extraction. 

Calcareous  bodies  have  been  repeatedly  found  in  the  veins  of 
man  and  several  observations  of  the  same  kind  have  been  made 
in  the  horse.  Spooner  found  them  in  the  abdominal  veins  and 
Simmonds  in  the  jugular.  Much  difference  of  opinion  has  ex- 
isted as  to  the  mode  of  formation  of  these  bodies  whether  by  cal- 
careous deposit  in  a  coagulum  or  by  degeneration  of  a  neoplasm 
in  the  vascular  wall.  Andral  held  the  latter  opinion,  and  Tiede- 
mann  and  Cruveilhier  found  the  bodies  connected  to  the  inner 
coat  of  the  vein  by  a  fine  membrane.  Morton's  cut  of  one  of 
Simmonds'  specimens  (Calculous  Concretions)  shows  a  structure 
in  successive  layers  having  their  centre  at  one  end,  evidently  cor- 
responding to  a  former  connection  by  pedicle.  Cornil  and  Ran- 
vier  says  ' '  .sometimes  there  are  seen  in  chronic  varices,   calcare- 


Hceinorrhage.  365 

oils  incrustations  in  the  form  of  plates,  nodules  or  spheres  with 
concentric  layers  .  .  .  calcareous  infiltration  is  seen  in  the  form 
of  spheres  or  phlebolites  in  the  varicose  diverticula.  An  exten- 
sive calcareous  induration  several  centimetres  in  length,  is  also 
sometimes  observed,  the  vein  being  transformed  into  a  calcareous 
tube  with  the  ramifications  also  varicose. 

The  calcareous  plates  of  the  vein  are  developed  in  the  fibrous 
and  internal  portion  of  the  middle  coat.  At  the  beginnirig  they 
consist  of  granules  deposited  in  the  fasciculi  of  the  connective 
tissue  or  between  them  ;  these  soon  unite  and  form  transparent 
plates  with  granular  strise." 

Phlebolites  in  the  jugular  suggest  a  connection  with  the  pouch- 
like dilatations,  and  transformations  in  the  vascular  walls  that 
have  been  subjected  to  phlebotomy.  It  is  probable  however 
that  there  is  usually  a  morbid  condition  of  sanguification  and  nu- 
trition which  predisposes  to  their  formation.  In  Simmonds'  case 
the  jugular  was  impervious  below  the  bodies,  there  was  hepatitis 
and  arthritis  of  the  fetlock  joint. 

When  recognized  during  life  these  may  be  extracted  with  due 
antiseptic  precautions,  if  the  vein  can  be  dispensed  with  it  may 
be  ligatured  above  and  below,  if  not  an  attempt  may  be  made  to 
preserve  it,  extracting  through  a  clean  cut  longitudinal  incision 
and  securing  as  perfect  coaptation  of  the  edges  of  the  wound  as 
possible. 


HEMORRHAGE. 


Arterial,  venous  and  capillary  haemorrhage  belong  almost  ex- 
clusively to  the  domain  of  surger)\  Internal  haemorrhages  will 
be  considered  in  connection  with  the  organs  in  which  they  take 
place. 


HEMOPHILIA. 

Definition.  Causes,  lack  of  plasticity  of  the  blood,  thin  walls,  blood 
tension,  cardiac  erethism,  hypertrophy  and  neurosis.  Sex.  Heredity- 
through  the  female.    Treatment,  depletive,  styptic,  astringent.    Transfusion. 

This  is  a  constitutional  infirniit}',  usuall}'  hereditary  and  char- 
acterized by  the  occurrence  of  profuse  and  continuous  bleeding  as 
the  result  of  otherwise  insignificant  injuries  or  even  apart  from 
any  recognizable  lesion.  It  has  been  attributed  to  a  slow  coagu- 
lation of  the  blood,  but  at  the  start  of  a  hseniorrhage  the  blood  is 
rich  in  corpuscles  and  coagulates  firmly.  It  has  also  been  as- 
cribed to  extreme  tenuity  of  the  vascular  walls,  but  this  has  only 
been  met  with  in  a  certain  proportion  of  the  cases.  Another  po- 
tent factor  is  a  permanent  over-filling  of  the  blood-vessels  (Tmmer- 
mann,  Delafield,  Prudden).  The  same  writers  attach  importance 
to  cardiac  erethism,  cardiac  hypertrophy,  and  certain  neurotic  in- 
fluences which  temporarily  increase  the  habituall}^  congestive  di- 
athesis. In  man  the  majority  of  victims  have  been  males,  per- 
haps becatise  most  subject  to  traumatisms.  On  the  contrary  the 
hereditary  transmission  is  mainly  through  the  female  members  of 
the  family.  The  families  are  very  prolific,  a  condition  counter- 
balanced by  the  death  of  the  majority  of  the  victims  at  an  early 
age.  Among  the  lower  animals  it  has  been  observed  in  horses 
consequent  on  castration  (Siedamgrotzky,  Kohne,  Friedberger 
andFrohner),  setoning  (Kohne,  Dieckerhoff),  and  an  ulcer  of  the 
leg  (Kohne). 

Treatment  consists  in  combating  plethora  and  constipation  by 
saline  purgatives.  The  subject  should  be  carefully  protected  from 
injuries.  Locally  use  styptics  such  as  matico,  muriate  of  iron, 
tannin,  alum  with  pressure.  Internally  ergot,  lead  acetate,  iron 
chloride,  tannin,  alum,  or  muriate  acids.  Transfusion  is  a  denier 
resort. 


366 


DISEASES  OF  THE  BEOOD. 

Obscurity  of  blood  changes.  Red  globules,  biconcave,  embr\onic. 
Source.  Escape  of  immature  red  globules.  White  globules,  eosinophile, 
ueutrophile,  uninuclear,  multinuclear,  lymphocyte,  granular  amoeboid,  strap- 
nucleated.  Conditions  of  increase.  Relation  to  microbes  and  their  pro- 
ducts. Blood  plates.  Destruction  of  red  globules  in  the  liver.  Numbers 
in  animals,  in  different  vessels  and  conditions. 

The  blood  is  the  common  medium  through  which  all  nouri.sh- 
ment  is  conveyed  to  the  tissues,  all  material  to  the  glands  for  se- 
cretion, or  transformation,  and  all  effete  matter  to  the  various 
emunctories  for  elimination.  It  is  beside  the  carrier  of  oxygen 
for  the  respiration  of  the  tissues,  and  the  seat  of  changes,  as  yet 
little  known,  effected  through  the  white  globules.  The  activities 
of  the  various  processes,  carried  on  by  the  fixed  tissue  cells  and 
nuclei  would  suggest,  that  any  disease  or  derangement  of  the.se 
processes  would  be  at  once  cognizable  in  changes  shown  in  the 
blood.  Yet  so  perfect  is  the  balance  of  sanguification  and  elimi- 
nation on  the  one  hand,  and  of  the  remaining  vital  processes  oh  the 
other,  that  it  has  hitherto  been  impossible  to  detect  in  the  blood 
such  changes  as  would  identify  the  great  majority  with  morbid 
processes.  Some  morbid  changes  are  however  recognizable  and 
it  is  important  that  the  significance  of  these  should  be  known. 

The  blood  is  a  liquid,  con.si.sting  of  a  plasma  holding  in  solution 
.serum  albumen,  serum  globulin,  fibrine-forming  elements,  sugar, 
urea,  .salts,  and  a  variety  of  other  .soluble  bodies,  and  floating  a 
series  of  semi-solid  organized  bodies,  the  red  and  white  globules. 

The  red  globule  is  however  seen  in  two  distinct  forms,  ist. 
The  biconcave  disc,  non-nucleated,  containing  a  colorless  .stroma, 
and  the  coloring  matter — haemoglobin.  2d.  The  embryonic  red 
globule,  large,  nucleated  and  rarely  biconcave.  The  latter  is  found 
in  the  blood  of  the  fcEtal  man  or  animal  and  persists  to  a  slight 
extent  for  .some  time  after  birth.  These  are  believed  to  be  formed 
from  the  embryonic  cell  and  from  the  cells  of  the  embryonic  liver, 
spleen,  and  marrow,  whereas  afterbirth  they  are  derived  from  the 
marrow  cell,  and  in  healthy  conditions  pass  the  nucleated  stage 
before  they  escape  into  the  blood.     In   pathological  anaemia  and 

367 


368  Veterinary  Medicine. 

after  severe  haemorrhages  the}'  escape  more  rapidl}^  probabh-  from 
both  spleen  and  marrow,  and  appear  in  the  blood,  even  of  the 
adult,  of  the  gigantic  size  and  nucleated  appearance  of  the  embry- 
onic red  globule. 

The  white  blood  globules  (leucocytes)  are  spherical,  about 
twice  as  large  as  the  red  globules,  and  are  readily  divisible  by  tlie 
acid  eosin  stain  into  two  kinds  :  ist.  Cells  which  are  deeply 
stained  by  eosin — eosinophile ;  and  2d.  Cells  that  do  not  take  on 
the  eosin  stain  —neutrophile  (Ehrlich). 

Howells  further  divides  these  white  globules  into  uninuclear 
and  multinuclear.  Of  the  uninucleated  he  describes  three  varie- 
ties :  a.  The  lymphocyte  which  is  non-granular  and  without  amoe- 
boid movement  ;  b.  The  granular  cell  with  a  plotoplasmic  envel- 
ope and  amoeboid  movement  ;  and  c.  The  granular  with  strap- 
shaped,  horseshoe  or  spiral  nucleus.  Like  Lovet  he  considers 
the  multinucleated  as  on  the  way  to  disintegration. 

We  cannot  as  yet  speak  with  confidence  of  the  pathological  .sig- 
nificance of  these  respective  forms  of  white  globules,  but  they  in- 
crease greatly  in  numbers  in  connection  with  certain  diseases  of 
lymph  plexus,  and  glands,  of  the  spleen  and  other  blood  glands, 
and  in  foci  of  inflammation,  and  they  perform  most  important 
functions  in  connection  with  the  resistance  of  microbian  invasion 
and  in  elaborating  the  antitoxines  which  confer  immunity  from 
second  attacks. 

The  next  form  of  blood  solids  are  the  blood-plates  of  Bizzozero, 
the  haematoblasts  of  Hayem.  These  are  nucleated  (Semmer)  dis- 
coid, le.ss  than  half  the  diameter  of  the  red  globules,  and  cluster 
together  in  granule  masses  when  the  blood  is  drawn.  Their  true 
significance  is  uncertain  though  it  has  been  .surmised  that  they  are 
intermediate  corpuscles  (Semmer),  that  they  are  the  disintegrated 
nuclei  of  the  leucocytes,  and  that  they  furnish  paraglobulin  to  the 
circulating  blood  (Schmidt,  Howell). 

The  liver  is  one  centre  for  the  destruction  of  red  blood  globules 
and  in  the  blood  of  the  hepatic  vein  there  may  be  a  reduction  of 
a  million  to  a  million  and  a  half  of  red  globules  per  cubic  centime- 
ter, as  compared  with  the  portal  vein. 

Malassez  gives  4,500,000  as  the  number  of  globules  in  a  cubic 
miUimeter  of  blood  (dog  and  horse  7,500,000,  Nocard).  The 
white  globules  are  to  the  red  in  the  proportion  of  about  i  to  300 


Plethora.     PolycBinia.  369 

(domestic  animals  i  :  800,  i  :  iioo,  Nocard).  The  variation  in 
different  parts  of  the  vascular  system  and  at  different  times  of  tlie 
day  is  striking  and  suggestive. 

In  the  blood  of  the  splenic  vein  i  :  60  ;  in  the  hepatic  vein 
I  :  170  ;  in  the  portal  vein  i  :  740  ;  in  the  morning,  fasting  i  :  716  ; 
half  an  hour  after  breakfast,  i  :  347  ;  in  boys  i  :  226  ;  in  girls 
I  :  389  ;  in  men  1:346;  in  old  men  1:381;  in  menstruating 
woman  i  :  247  ;  in  pregnant  woman  i  :  281,  (Strieker). 


PI.ETHORA.     POIvY^MIA. 

Definition.  Transitory  only.  Causes,  kidney  disease,  drinking  freely, 
rich  feeding,  profuse  secretion,  polycythemia,  hyperalbuminosa,  excess  of 
fibrine,  sugar  or  fat.  Ratio  of  blood  to  body.  Variations  of  globules. 
Symptoms,  general,  local.  Appearance  of  blood.  Prevention.  Treat- 
ment. 

Defi7iition.  An  excess  of  blood,  of  the  blood  globules,  or  of 
the  albuminoids. 

Formerl}^  accorded  an  important  place  in  pathology,  plethora 
has  been  entireh'  eliminated  from  some  recent  works.  The  actual 
amount  of  blood  varies  greatly  at  different  times,  rising  after  a 
free  consumption  of  food  or  drink,  and  falling  during  a  period  of 
abstinence.  A  healthy  activity  of  the  secretory  and  excretory 
organs  secures  a  fair  uniform  average  in  the  plenitude  of  the  cir- 
culatory system.  Moreover,  large  variations  are  not  in  them- 
selves rapidly  injurious.  Worm-Miiller  and  Cohnheini  intro- 
duced into  dogs  ten  to  twelve  per  cent,  of  the  body  weight  (fifty 
to  eighty  per  cent,  of  their  blood)  of  canine  blood  without  induc- 
ing fatal  results.  More  than  this  was  fatal.  In  non-fatal  cases 
a  reduction  to  the  normal  standard  is  speedily  secured. 

But  we  cannot  count  on  absolute  immunity  in  all  circumstances. 
Disease  of  the  kidneys,  or  drinking  water  to  excess,  determines  a 
surplus  of  water  and  urinary  salts  (serous  plethora,  polyaemia 
aquosa).  In  cases  of  rapid  gain  in  condition  from  rich  feeding, 
and  above  all  after  profuse  watery  .secretion  (diarrhoea,  diuresis, 
24 


370  Veterinary  Mediciiie. 

perspiration),  the  red  globules  are  relatively  increased  (plethora 
polycj'thsemica).  After  hearty  feeding  there  is  a  large  increase 
of  albumins  (plethora  hyperalbuminosa).  Fibrine-fonning  ele- 
ments are  apparently  in  excess  during  rheumatism,  pneumonia 
and  other  acute  inflammations.  Sugar  is  in  excess  after  a  sac- 
charine or  farinaceous  meal,  fat  in  obese  individuals,  after  con- 
sumption of  fat,  after  injuries  to  the  bone  marrow,,  and  after 
severe  diseases  with  much  destruction  of  albumen. 

The  ratio  of  blood  to  the  body  weight  is  :  In  birds  1:12  ;  in 
Guinea  pig  1:19;  in  rabbit  1:20;  in  cat  1:21  ;  in  dog  1:17  ;  in 
horse  1:18  ;  in  sheep  1:24  ;  in  pig  1:26  ;  in  ox  1:29  (Colin).  As 
showing  the  variation  under  even  different  normal  conditions  of 
the  system  Bollinger  found  the  blood  but  2.2  per  cent,  of  the 
body  weight  in  a  fat  pig,  whilst  it  was  13.5  per  cent,  in  a  draft 
horse.  Colin  found  it  2.4  per  cent,  in  the  fat  ox  instead  of  the 
usual  3.4  per  cent. 

The  excess  of  red  globules  and  usually  also  of  albumins  is  seen 
as  a  temporary  condition,  in  lean  but  vigorous  animals  put  sud- 
denly on  an  abundant  diet,  rich  in  assimilable  albuminoids,  in 
working  animals,  put  in  confinement  to  feed,  and  above  all  in 
high  conditioned  cows  after  an  easy  parturition,  when  the  uterine 
blood  has  been  suddenly  thrown  on  the  general  circulation  and 
the  emunctories  have  failed  to  establish  a  balance.  Also  in  the 
lymphangitis  occurring  after  a  day  or  two  of  rest,  in  a  horse  that 
has  been  hard  worked  and  heavily  fed. 

It  should  be  borne  in  mind  that  the  number  of  red  globules 
varies  considerably  in  the  different  animals.  In  the  dog  it  was 
by  weight  148.3  grammes  per  1000;  in  the  pig  105.7;  ^^  the 
horse  102.9;  in  the  ox  99.71,  and  in  the  sheep  98.2  (Andral, 
Gavarret,  Delafond).  By  count  the  horse  has  5,500,000  per 
cubic  millimeter  (7,500,000,  Nocard)  ;    and  the  dog  5,000,000. 

Symptoms.  Under  a  sudden  dangerous  increase  of  the  volume 
or  the  organic  elements  of  the  blood,  there  are  usually  dulness, 
lassitude,  dropping  of  the  head,  strong,  full,  hard  pulse,  extra 
force  in  the  heart  beats,  thirst,  elevated  temperature,  and  redness 
of  the  visible  mucous  membranes.  At  first  there  is  no  indication 
of  local  disease,  but  unless  relief  comes  by  free  secretion  some 
local  complication  is  likely  to  ensue.  This  may  be  epistaxis,  con- 
gestion or  apoplexy  of  the  brain,  parturition  fever,  lymphangitis, 


Hydrocemia.     Ance^nia   Oligczniia.  371 

or  congestion  of  some  internal  organ,  etc.  A  drop  of  blood  colors 
deeply  the  finger  or  other  object,  it  clots  firmly  in  three  to  five 
minutes,  and  shows  more  than  usualof  a  buffy  coat. 

Treatment.  As  dangerous  plethora  is  usually  a  very  transient 
condition  the  main  attention  should  be  given  to  prevention ,  in 
keeping  the  diet  low  and  the  emunctories  active  in  high  condi- 
tioned parturient  cows  ;  in  lowering  the  diet  and  securing  free 
secretion,  or  in  giving  exercise  to  high  fed,  hard  worked  horses 
that  have  been  laid  off  work  ;  in  changing  only  by  slow  grada- 
tions thin,  vigorous  animals  to  a  rich  diet,  etc.  When  the  danger 
is  imminent  prompt  relief  can  be  secured  by  the  liberal  abstrac- 
tion of  blood.  Purgatives,  diuretics,  and  restricted  diet  may  be 
applied  to  less  urgent  cases. 


HYDRO^MIA.     ANEMIA    OIvIG^MIA. 

Definition.  Causes  :  bleeding,  watery  repair,  hydrosetnia,  repair  of  glob- 
ules, changes  in  red  globules,  in  bone  marrow.  Cause  of  chronicity  :  pro- 
fuse secretions,  ;  moplasms  ;  parasites  ;  chronic  exhausting  diseases  ;  de- 
fective diet  or  hygiene  ;  diseases  of  jaws  or  throat :  overwork  :  toxic  sub- 
stances. Symptoms  :  pallid  mucosas,  weakness,  perspiration,  soft  tissues, 
small  pulse,  palpitation,  anaemic  heart — arterial  and  venous  murmurs,  depi- 
lation,  indigestion,  costiveness,  urine  clear,  abundant,  emaciation.  Lesions  : 
blood  poor  in  globules,  embryonic,  and  other  abnormal  red  globules,  fatty 
degeneration,  blood-clot.  Treatment  :  remove  causes,  diet,  hygiene,  sun- 
shine. 

Definition.  Bloodlessness  ;  Deficiency  of  blood  ;  I^ack  of  red 
blood  globules.  The  last  named  is  the  condition  to  which  the 
term  is  habitually  applied. 

Causes.  Anaemia  is  not  so  much  a  disease,  as  a  result  of  a 
great  many  debilitating  and  exhausting  conditions.  Haemorrhage 
the  most  direct  cause  of  anaemia  determines  at  first  an  actual  lack 
of  blood  (oligaemia)  and  of  blood  pressure,  which  may  be  suffi- 
cient to  cause  fainting  and  death.  In  case  of  survival  the  amount 
of  blood  is  rapidl}^  made  up  by  absorption  from  all  available 
sources  of  liquid  in  the  economy,  but  the  blood  so  restored  is  es- 
sentially hydroaemic  having  an  excess  of  water  and  a  lack  of  glob- 


372  Veterinary  Medicbie. 

iiles  and  dissolved  solids.  If  however  the  loss  has  been  moderate 
the  quality  may  be  restored  in  a  few  days.  Buntzen  found  that 
after  moderate  bleeding  the  volume  is  restored  in  a  few  hours  ; 
after  a  profuse  haemorrhage  in  24  to  48  hours.  After  bleeding  to 
I.I  to  4.4  per  cent,  of  the  body  weight  the  increase  of  the  red 
globules  may  be  noticed  after  24  hours,  and  is  completed  in  7  to 
34  days.  It  is  noteworthy  that  during  this  repair  the  bone  mar- 
row becomes  much  redder  and  more  cellular,  and  that  new  red 
cells  found  in  the  blood  are  nucleated  (Neumann)  and  contain 
less  haemoglobin  (Ott).  The  absence  of  haemoglobin  is  nearly  in 
proportion  to  the  amount  of  the  haemorrhage  (Bizzozero,  Sal- 
violi).  If  the  haemorrhage  is  slow  and  continuous  this  repair  is 
counterbalanced  and  the  anaemia  is  much  more  persistent. 

Profuse  secretion  as  of  milk  (cows,  goats,  ewes,  bitches,  on 
poor  feeding),  of  liquid  faeces,  urine,  or  pus  often  determine  a 
marked  and  even  dangerous  anaemia. 

The  rapid  growth  of  multiple  tumors  as  of  melanosis  in  gray 
horses  has  been  noticed  to  cause  profound  anaemia  (Bouley). 

Perhaps  no  cause  is  more  potent  than  the  attacks  of  parasites 
and  especially  such  as  live  by  sucking  the  blood.  The  numerous 
strongyli  of  the  lungs,  stomach,  and  intestine,  the  tricocephalus, 
and  allied  round  worms,  the  trematodes  of  the  liver,  and  the  cyto- 
dites  of  birds  furnish  striking  examples  of  the  bloodless  and  de- 
bilitated condition  which  they  may  produce.  In  man  ankylosto- 
mata  causes  anaemia  in  Egypt,  Italy  (St.  Gothard)  and  elsewhere, 
and  bothriocephala  in  different  countries. 

Chronic  exhausting  diseases  especially  those  which  affect 
the  digestive  organs  and  mesenteric  glands  are  prolific  causes.  So 
with  Bright's  disease. 

Connected  with  these  are  defects  in  diet  or  hygiene.  Starva- 
tion, unsuitable,  innutritions,  or  indigestible  food,  too  laxative 
food,  damp,  dark,  draughty  or  unventilated  stables,  and  irregu- 
larity in  feeding,  watering  and  work  are  all  potent  factors  in  in- 
ducing anaemia. 

Diseases  of  the  masticatory  apparatus  (broken  jaw,  dis- 
eased teeth,)  preventing  the  preparation  of  food,  and  pharyngeal 
troubles  interfering  with  deglutition  are  other  causes.  Finally 
overwork  is  not  to  be  forgotten. 

Toxic  anaemia  may  occur  from  the  ingestion  of  lead,  mercury, 
or  arsenic. 


Hydrocemia.     Ancsmia  Oligcemia.  373 

Symptoms.  These  may  be  little  marked  at  the  outset  in  slowly 
developing  cases.  Extra  pallor  of  the  mucous  membranes, 
fatigue  and  even  breathlessness  on  slight  exertion,  a  small,  weak, 
pulse,  with  a  tendency  to  become  rapid,  with  violent  heart  beats, 
when  excited. 

At  a  more  advanced  stage  the  mucosae,  especially  the  buccal, 
are  pale  and  thin,  the  muscles  are  soft,  flabby  and  weak,  fatigue 
and  perspiration  are  easily  induced,  the  feet  are  advanced  more 
nearl}^  in  the  median  line  of  the  body,  and  the  toes  strike  on  any 
obstacles,  the  pulse  is  weak,  small  and  quick,  and  the  heart  easily 
excited  even  to  palpitation,  and  with  an  occasional  anaemic  mur- 
mur with  the  first  heart  sound.  Arterial  and  venous  murmurs 
may  be  present.  The  hairs  are  easily  detached.  Appetite 
and  digestion  fail,  there  is  costiveness,  a  full  secretion  of 
urine  of  a  clear  aspect,  the  subcutaneous  fat  disappears  and  the 
skin  feels  thin  and  limp  (paper  skin  in  sheep),  the  hair  dry  and 
lusterless,  the  wool  flattened  (clapped).  The  weakness  and 
emaciation  go  on  increasing  and  dropsies  appear  in  the  limbs,  un- 
der the  trunk  and  jaw  and  in  the  internal  cavities. 

Pathology.  Lesio7is.  Apart  from  the  causes,  the  morbid  condi- 
tions are  mainly  found  in  the  blood.  The  watery  state  of  the 
blood,  the  lack  of  red  globules  (even  to  but  2,000,000  per  cubic 
millimeter),  the  absence  of  albumen  (76  per  1000  in  place  of  83), 
the  loose  coagiilum  with  excess  of  buffy  coat,  and  the  excess  of 
serum  are  characteristic.  The  presence  of  large,  nucleated 
(myelogenous)  red  cells,  of  spherical  bodies  smaller  than  the 
normal  red  cells  (microcytes),  and  of  irregularly  shaped  red 
calls  (poikilocytes)  is  characteristic,  the  latter  especially  of 
pernicious  anaemia.  As  the  disease  advances  fatty  degene- 
ration of  heart,  liver,  kidneys,  and  other  organs  are  compli- 
cations and  tend  to  aggravate  the  disease,  by  counteracting  repair 
of  the  globules — thus  establishing  a  vicious  circle.  All  the  organs 
are  pale  and  flaccid,  the  arteries  empty,  the  veins  contain  a  little 
blood,  forming  pale  clots.  In  the  cases  considered,  all  the  result 
of  another  disease,  the  lack  of  blood  and  of  the  solid  and  vital 
elements  in  that  which  remains,  entails  itnperfect  function  in  all 
the  vital  processes,  including  sanguification  itself,  and  in  this  way 
an  anaemia  once  established  tends  to  perpetuate  and  aggravate 
itself. 


374  Veterinary  Medicine. 

Treatment.  The  anaemia  above  considered  being  largely  symp- 
tomatic, or  resultant  from  other  diseases,  the  first  consideration  as 
regards  both  prevention  and  treatment  is  to  prevent  or  cure  such 
diseases.  Where  dietetic  or  hygienic,  a  liberal  diet,  and  good 
hygiene  will  meet  every  demand  in  the  early  stages.  In  the 
warm  season  an  open  air  life  is  most  important.  In  case  of  a 
drain  by  over-secretion  (milk)  this  must  be  judiciously  checked. 
In  bitches  it  will  often  be  needful  to  wean  several  of  the  puppies. 
A  rich  and  very  digestible  diet  (oats,  beans,  linseed,  oil  meal, 
milk,  gruel),  in  .small  compass,  and  suited  to  the  genus  and  indi- 
vidual, with  iron  and  bitters,  and  in  the  herbivora  carminatives, 
will  suit  many  cases.  Muriate  of  iron,  with  stry china  or  nux 
vomica  ;  iron  .sulphate,  sodium  chloride  and  nux  ;  or  dialysed 
iron,  or  some  other  soluble  ferruginous  salt,  with  quinia,  gentian, 
or  some  other  bitter  will  serve  a  good  purpose.  For  the  dog 
saccharated  carbonate  of  iron  or  citrate  of  iron  and  ammonia  with 
quinia  or  strychnia,  in  pill  form,. is  convenient.  With  poor  diges- 
tion muriatic  acid  and  pepsin  may  replace  the  iron  at  first.  Beef 
teas  may  often  be  given  with  advantage,  even  to  the  herbivora, 
and  injections  of  defibrinated  ox  blood  night  and  morning  have 
proved  of  service.  In  extreme  anaemia,  as  from  haemorrhage, 
transfusion,  or  its  equivalent,  must  be  resorted  to.  A  normal 
saline  solution  (0.6  per  cent.  NaCl),  boiled,  may  be  thrown  into 
the  peritoneum  or  subcutaneous  connective  tissue,  or  defibrinated 
blood,  may  be  injected  into  the  peritoneum.  Transfusion  is  the 
dernier  resort. 


PROGRESSIVE   PERNICIOUS    ANEMIA.      IDIOPATHIC 
ANEMIA. 

Definition.  Causes,  obscure,  faulty  diet,  hygiene,  microbes,  glycerine, 
pyrogallic  acid,  haemoglobin,  deranged  sanguification,  parasitisms.  Symp- 
toms, of  ancemia  of  obscure  origin.  Treatment  as  for  anaemia,  special 
measures,  for  intestinal  fermentations,  dietetic. 

Definition.  Anaemia  which  is  without  any  pre-exi.sting  appre- 
ciable cause. 

Causes.  As  in  the  corresponding  disease  in  man  the  real  start- 
ing point  of  pernicious  anaemia  is  unknown.  Faults  in  diet  and 
in  general  hygiene  have  been  adduced,  and  while  in  Berne  this 
appears  to  be  sustained,  in  Ireland,  in  the  poorest  classes,  the  disease 
is  little  known,  and  in  Montreal,  it  find  its  victims  largely  in  a 
class  of  well  to  do  arti,sans  (Osier.)  In  the  domestic  animal  it  is 
described  on  all  soils,  and  on  the  most  varied  dietary  (Bouleyand 
Reynal).  Zschokke  and  Friedberger  and  Frohner  in  cases  oc- 
curring enzootically  in  stables,  found  a  minute  bacillus  in  the  pa- 
tients, which  would  remove  these  cases  into  the  list  of  sympto- 
matic anaemia.  The  same  is  true  of  the  anaemia  (Surra)  of  horses 
and  mules  in  India  and  Siberia,  in  which  Evans,  Burke,  Steele 
and  Ignatovsky,  found  a  motile  spirilloid  organism  which  destroys 
the  red  globules.  Other  forms  that  are  apparently  purel}-  idio- 
pathic have  been  attributed  to  a  failure  in  the  cytogenic  proces.ses 
in  the  bone  marrow  especially.  Back  of  this  we  know  only  of 
the  various  debilitating  causes  in  food,  hygiene,  building,  loca- 
tion, work,  etc.,  operating  on  a  specially  susceptible  system,  in 
which,  once  started,  the  morbid  process  tends  to  perpetuate  itself 
and  increase. 

Ponfick  induced  anaemia  experimentally  b}^  the  intravenous  in- 
jection of  gl5xerine,  pj-rogallic  acid,  solutions  of  haemoglobin, 
etc.,  which  dissolve  the  blood  globules.  This  suggests  the 
probable  pathogenesis  by  the  production  of  unidentified  blood 
solvents  in  cases  of  deranged  sanguification,  but  it  still  leaves  us 
in  the  dark  as  to  the  exact  seat  of  such  derangements  (liver, 
blood  glands,  bone  marrow,  etc.)  and  as  to  the  cause,  parasitic  or 
otherv^'ise,  which  determines  such  disorder.     Pathological  investi- 

375 


37^  Veterinary  Medicine. 

gation  has  enabled  us  to  differentiate,  according  to  their  respec- 
tive causes,  a  number  of  diseases  (distomatosis,  lung  worms, 
ank3dostomiosis,  internal  acariasis,  chronic  trichinosis,  strongyli- 
asis,  etc.,)  which  were  formerly  classed  as  anaemias,  and  it  seems 
altogether  probable  that  the  onward  progress  of  medicine  will  en- 
able us  to  go  farther  in  the  same  direction  and  to  allot  the  remain- 
ing unclassed  anaemias  to  their  proper  etiological  places.  Some 
may  be  unrecognized  helminthiasis,  others  microbian  disorders, 
and  still  others,  disorders  in  nutrition  and  sanguification  from 
different  causes. 

The  Symptoms  are  those  of  other  forms  of  anaemia,  but  being 
more  obscure  in  origin  and  therefore  less  open  to  corrective  treat- 
ment, it  is  more  likely  to  grow  to  an  extreme  development  and  fa- 
tal issue.  The  weak  pulse,  irritable  heart,  debility,  unsteady 
walk  with  the  hind  limbs,  hurried  breathing  and  sweating  under 
exercise,  watery,  puffy  eyes,  dropsies  in  limbs  and  dependent 
parts  of  the  body,  progressive  emaciation,  and  weakness  are  even 
more  marked  than  in  symptomatic  anaemia. 

The  treatment  is  in  the  main  as  for  the  other  form  alike  in  its 
hygienic  and  medicinal  bearing.  In  man  recoveries  have  taken 
place  under  arsenic  combined  with  the  iron.  Arseniate  of  potash 
and  ferrum  redactum  in  pill  form,  or  tincture  of  chloride  of  iron, 
and  Fowler's  solution  in  food  or  water,  continued  for  a  length  of 
time.  Phosphated  pepsin,  and  peroxide  of  hydrogen  have  seemed 
to  do  well  in  some  instances,  and  phosphorated  oil  is  another  re- 
sort. W.  Hunter  attributes  idiopathic  anaemia  to  toxins  derived 
from  microbes  in  the  alimentary  canal,  as  Sir  Andrew  Clark  as- 
cribes chlorosis  to  a  similar  cause.  He  prescribes  beta-naphthol 
as  the  least  soluble  and  best  antiseptic,  in  a  dose  of  5  grains  daily 
in  mucilage  for  man  (i  drachm  for  horse  or  ox).  Hunter  fur- 
ther found  that  a  farinaceous  diet  protected  the  globules  against  de- 
struction while  a  nitrogenous  diet  favored  this.  It  may  be  noted 
that  long  ago  Delafond  attributed  anaemia  in  animals  to  the  ex- 
tension of  the  use  of  artificial  fodders  of  the  natural  order  legumi- 
nosae  which  are  rich  in  nitrogen. 


CHRONIC  ANEMIA .     DROPSY  IN  CATTLE  AND  SHEEP. 
Definition.     Causes,   parasitic   and   microbian.     Symptoms.     Treatment. 

Definition.  A  progressive  aiisemia  in  ruminants  and  other  ani- 
mals, resulting  in  general  anasarca,  and  dropsies  of  the  internal 
cavities. 

In  veterinary  works  publi.shed  on  the  European  Continent  this 
affection  is  given  a  special  place  apart  from  the  same  train  of 
symptoms  which  mark  distomatosis,  taeniasis,  and  strongylia- 
sis.  The  disease  is  described  as  prevailing  in  wet  j'^ears,  after  in- 
undations, when  the  vegetation  is  rank  and  aqueous,  and  of  course 
largely  aquatic,  in  animals  that  are  turned  out  in  early  morning 
before  the  dew  has  evaporated,  in  the  conditions,  in  other  words, 
that  favor  the  ingestion  of  parasites.  It  prevails  also  in  work  oxen 
fed  on  the  refuse  of  sugar  factories  (beets,  turnips)  in  which  the 
nitrogenous  materials  are  held  to  be  deficient,  but  in  Great  Britain 
where  cattle  are  often  fattened  on  an  exclusive  diet  of  turnips, 
containing  even  a  larger  proportion  of  water,  this  non-parasitic 
disease  is  unknown.  It  is  also  ascribed  to  close,  ill- ventilated, 
unwholesome  buildings,  and  to  over-kept  and  tainted  fodder,  and 
so  far  as  a  separate  disease  exists,  it  seems  more  reasonable  to 
charge  it  to  the  toxins  produced  by  bacterial  ferments  or  crypto- 
gams than  to  causes  which  elsewhere  appear  to  be  inoperative. 

The  symptoms  are  essentially  those  of  distomatosis,  and  the 
treatment,  apart  from  the  parasiticides,  is  the  same.  When  hel- 
minthiasis can  be  certainly  excluded />;-^zr«/^?^  would  include  the 
avoidance  of  the  factory  refuse,  especially  when  in  a  state  of  decay. 


377 


MEIvAN^MIA.     BLACK  PIGMENT  IN  BLOOD. 

Definition.  Melanin,  in  normal  tissues,  abnormal.  Melanosis.  Bisul- 
phide of  carbon  subcutem.  Decomposition  of  hsenioglobin  in  leucocytes. 
Coloration  of  tissue. 

Definition.  Accumulation  of  granules  and  .scales  of  blood  pig- 
ment (melanin)  in  the  circulating  fluid,  and  in  various  organs 
(spleen,  liver,  bone  marrow,  brain,  etc). 

Melanin  — C„. 2,  H3,  Ny.g,  O.^.g — or  black  pigment  (a  close  rela- 
ative  of  haematin)  occurs  physiologically  in  epithelium  (choroid, 
retina,  iris,  in  the  deeper  layers  of  epidermis,  and  on  the  surface 
of  the  dog's  lung  and  of  the  sheep's  brain)  and  in  connective  tis- 
sue corpuscles  (lamina   fusca  of  the  choroid). 

Pathologically  it  is  found  in  the  blood  of  the  victims  of  malarious 
fever,  often  in  great  abundance,  and  in  the  spleen,  liver,  bone 
marrow,  brain,  lymph  glands  and  some  other  organs.  It  is  form- 
ed abundantly  in  the  black  pigment  tumors  (melanosis)  of  man 
and  animals,  and  in  extensive  melanosis  is  present  in  the  blood  of 
both  man  and  horse  (Schimmeln).  So  far  it  has  not  been  found 
in  connection  with  the  extensive  destruction  of  red  globules  which 
takes  place  in  anaemia.  Schwalbe  has  developed  malansemia  ex- 
perimentally by  the  hypodermic  injection  of  bisulphide  of  carbon 
in  rabbits. 

According  to  one  view  the  melanin  is  produced  in  connection 
with  the  destruction  of  red  globules  in  the  liver,  .spleen,  etc.,  and 
is  thence  carried  into  the  blood.  This  is  in  keeping  with 
the  local  formation  of  the  pigment  in  melanosis.  Arnstein  how- 
ever urges  that  in  malarious  cases  the  destruction  of  the  red  cells 
takes  place  in  the  blood,  and  that  the  haemoglobin,  absorbed  into 
the  leucocytes,  is  transformed  into  melanin,  and  finally  deposited 
in  the  tissues  by  the  migrating  white  corpu.scle.  Why  the  hae- 
moglobin .set  free  in  anaemia  is  not  similarly  transformed,  does 
not  appear.  The  pigmented  organ  may  be  quite  black  in  the  im- 
mediate vicinity  of  the  blood  vessels,  and  in  its  general  aspect  in 
chronic  ca.ses  reddish  brown,  dark  gray,  or  dark  olive. 


378 


IvEUK^MIA.     LEUCOCYTH^MIA. 

Definition.  Nature.  Result  of  other  morbid  processes.  Leucocytes 
polynuclear.  Lymphatic  leukaemia.  Spleno-myelogenous  leukaemia. 
Leucocytes  in  each.  Loss  of  amoeboid  movement.  Charcot's  crystals. 
Haematoblasts.  Cell  increase  in  bone  marrow.  Myelocytes.  Enlarged 
spleen  and  lymph  glands.  Haemorrhages.  Lyniphoid  growths.  Suscepti- 
ble genera.  Causes  obscure.  Symptoms,  pallor,  listlessness,  weakness, 
apncea,  sweating,  thirst,  emaciation,  weak  circulation,  anaemic  murmur, 
enlarged  spleen,  bleedings,  diarrhoea,  dropsy,  excess  of  white  globules, 
reduction  of  red  globules,  buffy  coat,  beaten  fibrine  is  granular,  china- 
white  mucosae,  hurried  breathing,  stertor,  deranged  digestion,  marasmus. 
Duration.  Not  inoculable.  Treatment,  not  hopeful,  as  for  anaemia,  good 
hygiene,  tonics,  stimulants,  antiseptics. 

Definition.  An  excessive  and  persistent  increase  of  the  white 
blood  globules,  and  associated  with  enlargement  of  the  spleen, 
lymph  glands  or  bone  marrow. 

Nature.  This  must  be  distinguished  from  the  leucocytosis  which 
occurs  during  digestion,  or  that  which  attends  on  tuberculosis, 
glanders,  pneumonia,  and  other  extensive  inflammations  and  pro- 
fuse suppuration.  These  forms  are  transient  and  the  cells  are  of 
the  polynuclear  variety.  The  cells  of  leukgemia  are  various  in 
character,  but  bear  some  relation  to  the  particular  organ  which  is 
the  seat  of  hypertrophy  or  morbid  process. 

"  In  lymphatic  leukaemia  the  increase  in  the  number  of  leu- 
cocytes is  due  to  the  mononuclear  lymphocytes,  especially  of  the 
small  form.  As  many  as  ninety-five  per  cent,  of  the  colorless 
cells  may  be  of  this  form.  In  Spleno-Myelogenous  leukaemia 
the  eosinophile  cells  may  be  especially  increased  in  number,  and 
there  are  also  large  leucocytes  coming  apparently  from  the  mar- 
row of  the  bones,  and  called  myelocytes.  These  most  nearly  re- 
semble the  larger  lymphocytes  of  normal  blood,  but  they  are  usu- 
ally larger.  They  have  a  single  large  nucleus  which  stains  feebly 
and  their  bodies  may  show  neutrophile  granules.  Larger  and 
smaller  nucleated  red  blood  cells  may  be  found  in  spleno-myeloge- 
nous leukaemia.  The  leucocytes  are  frequently  in  a  condition  of 
fatty  degeneration,  and  there  may  be  a  decrease  in  the  number  of 
red  blood  cells.  "      (Delafield  and  Prudden).     In  splenic  leucocy- 

379 


380  Vetermary  Medicine. 

thaemia  blood  plates  may  be  absent  and  in  lymphatic  leucocythae- 
mia  they  may  be  in  excess. 

Cafavy  claims  that  many  of  the  leucocytes  have  lost  their  ac- 
tive amoeboid  movements. 

Bright  white  crystals  in  the  form  of  elongated  octahedra  are 
found  nor  only  in  the  blood  but  in  the  diseased  glands,  spleen  or 
marrow  (Charcot's  crystals).  Clusters  of  discoid  hsematoblasts 
(blood  plates)  are  present  in  the  blood  in  variable  numbers 
(Schultze's granule  masses). 

The  bone  marrow  is  marked  by  an  accumulation  of  spheroidal 
cells,  which  tend  to  pass  into  a  condition  of  fatty  degeneration. 
Most  of  them  are  colorless,  larger  than  the  lymphocytes  of  normal 
blood  and  have  one  large  often  vesicular  nucleus,  staining  less 
highly  than  the  lymphocyte  nuclei,  and  with  neutrophile  granules 
in  the  protoplasm  (myelocytes).  There  are  besides,  nucleated 
red  blood  cells,  spheroidal  cells,  containing  red  blood  cells,  and 
Charcot's  crystals.  The  marrow  may  be  uniformly  red,  mottled 
gray  and  red,  gray,  grayish  yellow,  or  puriform  (Delafield  and 
Prudden).  This  may  affect  one  or  many  bones.  The  affected 
spleen  is  usually  much  enlarged,  at  first  uniformly,  later  uneven- 
ly, firm  or  softened,  and  with  thickened  white  capsule.  The  cut 
surface  is  smooth,  brownish  red,  or  yellow,  with  white  lines 
(thickened  trabeculae)  and  indistinct  Malpighian  corpuscles.  It 
contains  glutin,  glycocoll,  hypoxanthin,  zanthin,  leucin,  ty rosin, 
and  lactic,  acetic,  or  formic  acids. 

The  affected  lymph  glands  are  somewhat  enlarged,  red  or  gray, 
exceptionally,  softened  or  caseated  and  otherwise  contain  an  excess 
of  leucocytes. 

Slight  haemorrhages  may  appear  in  any  of  these  structures. 
Lymphoid  growths  may  appear  in  a  number  of  other  organs  as 
the  liver,  heart,  lungs,  kidneys,  bowels,  tonsils,  the  different 
blood  glands,  the  serosse  and  the  retina. 

Genera  affected.  It  has  been  seen  mainly  in  dogs,  but  also  in 
horse,  ox,  pig,  cat  and  mouse.  Nocard  has  collected  the  follow- 
ing cases  :  horse  9,  cattle  6,  pig  5,  dog  22,  cat  i. 

Ivcisering  found  a  horse's  spleen  weighing  2S  kilogrammes. 
Johne  found  a  pig's  spleen  of  2.4  kilogrammes.. 

Causes.  The  primary  causes  of  leukaemia  are  unknown.  As  in 
anaemia  all  unhygienic  conditions  are  invoked  as  causes.     That 


Leiikcvmia.     Lcucocythaniia.  381 

it  is  not  due  to  simple  hypertrophy  or  irritation  of  the  leukogenic 
centers  is  plain,  as  it  does  not  follow  on  ordinary  diseases  and  in- 
juries of  these  parts,  but  what  is  the  precise  nature  of  the  morbid 
cause  has  so  far  eluded  us. 

Symptoms.  Pallor  of  the  visible  mucous  membranes,  listless- 
ness,  lack  of  energy  and  endurance,  breathlessness  and  perspira- 
ration  on  the  slightest  exertion,  ardent  thirst,  rapidly  advancing 
emaciation,  unsteady  gait,  stiffness  or  lameness,  lies  most  of  the 
time,  walks  with  pendent  head,  and  jaws  open,  small,  weak 
pulse,  anaemic  murmur  in  the  heart,  enlarged  lymph  glands,  or 
spleen  felt  beneath  the  left  lumbar  transverse  processes  in  the  ox, 
or  in  the  left  hypochondrium  in  the  horse.  Bleeding  from  the 
nose  or  elsewhere,  slight  haemorrhage  into  the  conjunctiva,  irri- 
table conditions  of  the  bowels,  diarrhcEa  and  dropsies  are  sug- 
gestive. The  blood  when  obtained  in  epistaxis  or  drawn  by  a 
needle  prick  may  be  pale  rose,  brownish  or  grayish  brown  instead 
of  red,  and  under  the  microscope  shows  the  enormous  excess  of 
leucocytes — the  ratio  to  the  red  being  sometimes  1:2,  or  even 
more,  in  the  human  subject.  In  the  domestic  animals  the  fol- 
lowing ratios  have  been  made  by  actual  count :  1:85  (Leblanc 
and  Nocard),  1:50,  1:45  (Mauri),  1:20  (Nocard),  1:15  (Siedam- 
grotzky),  1:12  (Forestier  and  Laforque).  The  normal  average 
for  the  domestic  animal  according  to  Nocard  is  1 1900.  This  great 
relative  excess  of  white  globules  serves  to  distinguish  this  malady 
from  anaemia,  and  its  persistency  is  a  means  of  diagnosis  from 
transient  leucocytosis. 

The  red  globules  are  always  reduced  in  number  in  the  horse 
and  dog  to  5,082,000,  and  even  2,050,000  per  cubic  millimetre, 
while  the  normal  is  7,500,000  (Nocard). 

In  clotting,  the  blood  forms  an  extensive  buffy  coat,  and  in  soli- 
pedes  which  normally  show  this,  the  blood  set  in  a  test  tube 
forms  three  strata,  the  upper  slightly  yellow,  semi-transparent 
and  formed  of  fibrine  ;  a  median  of  a  dull,  opaque  white  color 
and  formed  mainly  of  leucocytes  and  blood  plates,  and  a  lower  of 
a  violet  red  and  formed  mainly  of  red  globules. 

The  amount  of  fibrine  is  variable.  It  becomes  granular  when 
beaten.     Albumen  is  variable  but  usually  reduced. 

The  visible  mucous  membranes  are  bloodless  and  of  a 
clear  porcelain  white.     The  w^alk  becomes  weaker,  fore  feet  wide 


382  Veterina7'y  Medicvie. 

apart  and  the  hind  limbs  partly  flexed,  head  and  neck  extended, 
and  breathing  labored.  The  breathing  may  be  with  constant 
stertor,  the  bowels  torpid  and  tympanitic,  or  loose  and  foetid,  drop- 
sies and  haemorrhages  ensue,  and  the  patient  dies  in  complete 
marasmus. 

Duration.  The  disea.se  may  prove  fatal  in  less  than  a  month, 
or  it  may  last  for  three,  six,  or  eight  months.     It  is  mostly  fatal. 

Not  inoculable.  Many  attempts  have  been  made  to  transmit  it 
by  inoculation,  but  in  no  case  with  success. 

Treatjnent  is  not  successful.  All  hygienic  measures  should  be 
adopted,  as  for  anaemia  ;  open  air  and  sunshine,  with  protection 
against  chills  ;  the  treatment  of  all  complications;  iron,  bitters, 
phosphorus,  arsenic  in  particular,  electricity  to  the  spleen,  mas- 
sage ;  oxygen  inhalation  ;  and  locally,  iodide  of  potassium  or 
mercury,  generally  and  locally. 


LYMPHADENOMA.     HODGKIN'S  DISEASE. 

Definition.  Relation  to  leukaemia.  Causes.  Mainly  accessory.  State  of 
lymph  glands,  spleen,  liver,  bone  marrow,  intestine,  tonsils,  thymus,  kid- 
neys, liver,  lungs,  bronchial  mucosa,  pleura,  pericardium,  nervous  system. 
Symptoms,  as  in  leukaemia,  with  adenoid  hyperplasia,  but  little  leucocy- 
themia.  Relation  to  glanders.  Uric  acid,  low  density,  no  hippuric 
acid.  Tuberculin  and  mallein  tests.  Treatment,  as  in  leukaemia. 
Excision  in  cases  not  constitutional.     Phosphorus,  phosphide  of  zinc. 

Definition.  Hypertrophy  of  the  lymphatic  glands  with  little 
or  no  leucocytosis.  There  may  further  be  lymphoid  growths  in 
the  liver,  spleen,  bone  marrow  and  other  organs. 

The  visceral  lesions  in  lymphadenoma  do  not  differ  in  charac- 
ter from  those  of  leukaemia,  and  as  it  does  often  apparently  merge 
into  that  disease  by  the  characteristic  changes  in  the  blood,  it  is 
denied  by  many  that  it  constitutes  a  separate  pathological  entity. 
In  his  admirable  monograph  on  leucaemia  in  the  lower  animals 
Nocard  affirms  their  identity.  The  main  excuse  for  keeping  up 
an  alleged  distinction,  is  the  frequent  absence  of  leucoc5'tosis,  and 
this  often  supervenes  after  the  lymphadenoma  has  existed  for 
some  time. 


Lyiuphadcnoina.     HodgJdn' s  Disease.  383 

Causes.  As  in  leucsemia,  no  definite  cause  can  be  found  in  the 
majority  of  cases.  An  accessory  cause  can  sometimes  be  observed 
where  a  local  irritation  gives  rise  to  swelling  of  the  adjacent  lym- 
phatic glands  and  this  goes  on  to  distinct  Ijanphadenoma. 

Lesions  in  the  Lymph  Glands.  The  hyperplasia  may  affect 
but  a  single  group  of  glands,  more  commonly  a  number  of  groups, 
and  often  nearly  all.  In  one  case  only  of  leukaemia  in  the  lower 
animals,  a  dog,  has  Nocard  failed  to  find  the  lymph  glands 
affected.  In  the  horse  he  has  found  the  sublumbar  glands  alone 
weighing  14.5  kilogrammes,  11  k.  and  8  k.  They  compressed 
the  posterior  aorta  and  vena  cava  and  had  caused  extensive  ascites. 

The  enlarged  glands  are  white,  gray  or  in  case  of  rapid  growth 
veined  or  pointed  with  red  ;  they  may  be  soft  or  firm  according 
as  the  hyperplasia  has  operated  most  on  the  trabeculae  or  the  cells  ; 
they  are  homogeneous  throughout.  The  scraping  of  the  cut  sur- 
face gives  a  more  or  less  thick  milky  juice  containing  a  great 
number  of  nucleated  or  double  nucleated  lymphocytes,  free  nuclei 
and  granules  which  stain  strongly. 

Hardened  sections  show  an  enormous  development  of  the 
follicles  at  the  expense  of  the  medullary  walls,  and  double  nu- 
cleated white  globules  packed  in  a  rich  reticulum  of  adenoid  tis- 
sue, whilst  the  blood-vessels  in  the  connective  tissue  are  crowded 
with  white  cells,  and  there  are  slight  ruptures,  old  or  recent. 

Lesions  of  the  Spleen.  These  are  nearly  always  present. 
Leisering  found  a  horse's  spleen  over  three  feet  long  and  28  lbs. 
weight,  and  Nocard  one  of  13  lbs.  Bollinger  found  a  pig's  spleen 
3^  lbs.  Siedamgrotzky  found  dog's  spleens  over  2  lbs.  The 
consistency  is  usually  firm  (sometimes  soft  in  dog).  Capsule 
thickened  and  white,  cut  surface  dry,  reddish  brown,  granular, 
Malpighian  bodies  enlarged  like  a  pea,  hazel  nut  or  walnut,  with 
contents  as  in  the  lymph  follicles.  The  capillaries  are  enlarged 
and  crowded  with  white  cells. 

Lesions  in  the  Liver.  The  liver  is  enlarged  in  one-half  of 
the  cases  of  leukaemia  in  the  lower  animals.  It  has  been  found 
to  weigh  20  lbs.  in  the  horse,  and  4  lbs.  in  the  dog.  It  is  of  a 
grayish  brown,  or  yellowish  brown  hue,  or  light  red  .spotted  with 
yellow,  or  mapped  out  by  anastomosing  grayish  white  lines. 
There  may  be  enlargement  of  the  acini,  or  the  formation  of  little 
nodes  of  adenoid  tissue,  or  most  commonlj'  in  the  lower   animals, 


384  Veterinary  Medicine. 

there  is  an  adenoid  thickening  of  the  bands  of  connective  tissue 
extending  in  from  the  capsule.  These  are  filled  with  white  cells 
which  stain  deeply  with  carmine.  There  may  also  be  slight  ex- 
travasations of  blood  and  infarcts. 

Lesions  in  the  Bone  Marrow.  These  noticed  in  the  pig  by 
Fiirstenberg,  and  in  dogs  by  Siedanigrotzky,  consist  in  increased 
vascularity,  great  cell  hyperplasia,  and  formation  of  adenoid  tissue 
as  described  under  leukaemia. 

Lesions  of  the  Intestine.  These  commence  in  the  agmina- 
ted  or  solitary  glands,  which  become  enlarged,  causing  thicken- 
ing of  the  mucous  membrane,  and  later  grow  out  into  more  or 
less  rounded  masses  of  lymph — adenoid  tissue  up  to  an  inch  in 
thickness.     They  are  quite  subject  to  ulcerations. 

Lesions  of  the  Tonsils.  Bollinger,  Nocard  and  Siedam- 
grotzky  found  these  enlarged  in  dogs  in  connection  with  adenoma 
of  the  spleen.  They  were  soft,  friable,  grayish,  and  consisted  of 
a  very  delicate  and  fragile  adenoid  tissue. 

In  one  case  Siedanigrotzky  found  adenoid  hypertrophy  of  the 
thymus  in  a  cow,  and  adenoma  of  the  kidneys  similar  to  that  of 
the  liver  has  been  noticed. 

Similar  adenoid  hyperplasia  has  been  found  in  the  lungs,  the 
bronchial  mucous  membrane,  the  pleura,  the  mediastinal  and 
bronchial  glands,  and  the  pericardium.  In  man  this  has  invaded 
the  nerve  centres,  and  it  seems  that  at  any  point  where  there  is  a 
lymph  gland  or  a  lymph  plexus  this  adenoid  hyperplasia  may 
localize  itself. 

Symptoms.  The  general  symptoms  of  failing  health  are  as  de- 
scribed in  leukaemia.  The  particular  symptoms  of  this  disease 
consist  in  the  recognition  of  the  adenoid  hyperplasia  in  the  ab- 
sence of  a  marked  leucocytosis.  The  submaxillary  glands  are 
usually  the  first  attacked,  and  the  disease  maj^  in  the  horse,  be 
confounded  with  glanders.  There  is,  however,  no  pituitary  dis- 
charge nor  ulcer,  the  glands  are  enlarged  symmetrically  on  the 
two  sides,  and  a  careful  search  will  usually  discover  other  groups 
with  similar  symmetrical  enlargement.  The  parotidean,  the 
pharyngeal,  the  prepectoral,  the  prescapular,  the  axillary,  the 
popliteal,  the  prefemoral,  the  post  and  premammary,  and  the 
inguinal  should  be  critically  examined.  The  enlarged  mesenteric 
glands  may  be  reached  and  detected  by  the  hand  engaged  in  the 


Lymphade7ioma.     HodgkUV s  Disease.  385 

rectum,  or  in  the  small  animals  b}^  external  palpation,  as  may 
also  the  enlarged  spleen  or  liver. 

The  adenoid  hyperplasia  in  the  chest  offers  very  obscure  and 
uncertain  symptoms.  The  enlarged  bronchial  and  mediastinal 
glands  may  seriously  interfere  with  the  functions  of  the  vagus 
nerve,  causing,  in  cattle,  disturbed  digestion  and  rumination  and 
tympanies,  in  horses  stertorous  breathing,  and  in  the  carnivora 
and  omnivora  a  tendency  to  vomiting.  In  animals  generally  the 
pressure  on  the  cardiac  nerves  leads  to  great  irritability  of  the 
heart,  and  violent  action  under  any  exertion.  The  prominent 
dyspnoea  in  the  advanced  stages  may  be  explained  by  these 
thoracic  hyperplasiae. 

Nocard  claims  that  the  urine  furnishes  most  important  indica- 
tions in  its  low  specific  gravity  (horse  loio),  its  constant  acidity, 
and  in  the  almost  entire  absence  in  that  of  the  horse  of  hip- 
puric  acid.  When  there  is  any  suspicion  of  tuberculosis  or 
glanders,  the  tuberculin  or  mallein  test  will  decide. 

Tf-eatment  is  essentially  the  same  as  in  leukaemia,  and  equally 
unsatisfactory.  Arsenic  has  in  the  main  given  the  best  results. 
In  the  very  earliest  stages  when  the  granular  hyperplasia  is  con- 
fined to  one  group,  excision  is  advisable.  This  should  be 
avoided  in  all  cases  in  which  the  constitutional  symptoms  have 
developed.  Phosphorus  and  phosphide  of  zinc  have  seemed  ben- 
eficial in  certain  hands.  Injections  into  the  glands  have  so  far 
proved  useless. 


25 


ACUTE  LYMPHANGITIS  OF  PLETHORA  IN   HORSE. 
ANGEIOEEUCITIS. 

Definition.  Symptoms  and  causes.  Genera  affected.  Causes  of  plethora. 
High  feeding.  Work  followed  by  rest.  Fever,  hurried  breathing,  strong, 
rapid  pulse,  anorexia,  stiffness  and  swelling  in  a  hind  limb,  inguinal  glands, 
connective  tissue  engorgement,  corded  lymphatics,  suppuration  rare.  Mild 
forms.  Lesions,  in  lymphatic  vessels  and  glands.  Chronic  cases.  Nature, 
plethoric,  lymph  excess,  stasis,  excess  of  cells  and  fibrine,  immunity  of  the 
fore  limb.  Season  of  prevalence.  Climate.  Diagnosis,  from  farcy,  erysipi- 
las,  etc.  Treatment,  exercise,  friction,  resolvents,  purgative,  bleeding,  di- 
uretics, astringents,  iodine,  pressure,  diet.  Prevention.  Treatment  of 
chronic  cases. 

Definition.  Inflammation  of  the  lymphatic  vessels  and  glands 
of  one  limb  usually  in  connection  with  rest. 

Symptoms.  This  affection  is  common  in  heavy  dr^ft  horses  of 
a  lymphatic  temperament  and  kept  on  high  feeding  and  at  hard 
work.  It  rarely  develops  however  while  the  subject  is  kept  at 
steady  work.  But  if,  in  the  midst  of  such  work,  the  horse  is 
kept  at  rest  in  the  stall  over  one,  two,  or  more  days  on  the  same 
generous  diet,  he  is  found  shivering  violently,  with  rapid,  labored, 
breathing,  high  pulse  and  elevated  temperature,  symptoms  which 
have  been  frequently  mistaken  for  those  of  pneumonia.  There  is 
complete  anorexia,  and  often  ardent  thirst.  The  patient  is  indis- 
posed to  move  and  if  forced  to  it  shows  lameness  in  one  hind  limb 
with  an  extraordinary  abduction  of  the  limb  at  each  step,  and 
sometimes  .so  severe  as  to  prevent  his  putting  his  full  weight  upon 
it.  If  an  examination  is  now  made  high  up  in  the  groin  close 
outside  the  inguinal  ring,  the  lymphatic  glands  will  be  found  to 
be  swollen,  hot  and  tender,  so  that  under  even  moderate  pressure 
the  leg  will  be  lifted  and  abducted  until  the  patient  threatens  to 
fall  on  the  other  side. 

A  little  later  the  shivering  may  have  given  way  to  the  hot  stage, 
with  it  may  be  general  perspiration,  and  the  swelling  may  have 
extended  down  the  course  of  the  saphena  vein  and  lymphatics, 
as  a  distinct  ridge  and  the  lower  part  of  the  limb  from  the  foot  to 
the  hock  may  be  filled,  dropsical  and  hot.  Unless  checked  the 
swelling  goes  on  increasing  till  the  lower  part  of  the  limb  is  two 
386 


Acute  Lymphangitis  of  Plethora  in  the  Horse.  387 

or  three  times  its  natural  thickness,  and  the  swelling  has  extended 
well  up  on  the  thigh.  The  swelling  has  a  soft  oedematous  feeling, 
easily  receiving  and  retaining  the  imprint  of  the  finger  and  is  not 
only  hot,  but  excessively  tender.  From  the  margin  of  the  swell- 
ing, firm,  tender,  rounded  cords  are  found  to  emerge  passing  up- 
ward along  the  line  of  thesaphena  vein  and  its  branches  toward  the 
inguinal  glands.  These  represent  the  swollen  and  gorged 
lymphatic  trunks,  and  may  often  be  traced  for  some  distance  into 
the  substance  of  the  general  engorgement. 

When  the  inflammation  is  violent,  suppuration  may  ensue  at  one 
or  several  centers,  but  more  commonly  the  engorgement  goes  on 
increasing  and  when  the  febrile  attack  has  subsided  the  limb  is 
left  permanently  enlarged  and  correspondiiigly  liable  to  a  second 
attack. 

Milder  cases  are  met  with  which  are  perhaps  even  more  mis- 
leading. There  may  be  little  or  no  rise  of  temperature,  loss  of 
appetite  or  general  constitutional  disturbance,  but  under  some 
change  of  regimen  and  particularly  after  one  or  two  days  of  rest 
the  subject  becomes  lame  in  one  hind  limb,  without  any  of  the 
usual  injuries  to  account  for  it.  Examination  of  the  groin  shows 
swelling  and  tenderness  of  the  external  inguinal  glands,  with  or 
without,  a  tender  cord-like  swelling  running  down  from  them. 

Between  these  two  types  may  be  found  all  grades  of  lymphatic 
inflammation  with  a  varied  degree  of  attendant  constitutional  dis- 
turbance. 

Lesions.  The  coats  of  the  inflamed  Ij^mphatic  vessels  are 
thickened  by  exudate  and  the  outer  coat  is  the  seat  of  ramified 
redness  with  minute  spots  of  blood  extravasation.  The  inner 
coat  is  dull,  opaque,  or  even  thickened.  The  vessel  is  dilated 
and  its  walls  friable.  The  contained  lymph  in  the  intervals  be- 
tween the  valves  has  coagulated  into  a  very  thin  diffluent  jelly- 
like clot,  which  in  old  standing  cases  may  have  become  granular. 
The  connective  tissue  from  which  these  vessels  lead  is  infiltrated 
with  liquid  and  the  lacunar  spaces  distended.  Red  patches  from 
blood  extravasations  are  numerous.  The  external  inguinal 
glands  and  often  the  internal  and  sublumbar  are  swollen,  con- 
gested, and  the  seat  of  active  cell  hyperplasia.  Abscesses  are  ex- 
ception all}^  .seen. 

In  chronic  cases  the  lymphatic  vessels  of  the   affected  limb  and 


388  Veterinary  Medicine. 

especially  of  the  lower  part  which  is  permanently  swollen,  are 
enormously  increased  in  calibre  (lymphangiectasis),  and  have 
their  walls  correspondingly  thickened.  The  connective  tissue  is 
the  seat  of  extensive  fibrous  hyperplasia,  and  its  interstices  are 
greatly  enlarged. 

Causes.  Nature.  This  disease  has  not  been  sufficiently  studied 
to  ascertain  what  toxic  agents  are  produced  in  the  plethoric  con- 
dition, under  the  torpid  processes  of  nutrition  and  sanguification 
entailed  by  absolute  compulsory  rest.  A  consideration,  hov/ever, 
of  the  relations  of  the  lymph  and  lymph  vessels  and  glands  to 
other  parts  will  in  part  explain  the  pathology  of  the  malady. 
The  lymphatics  take  their  origin  in  the  nuclear  spaces  of  the 
various  tissues,  the  anastomosing  canals  of  such  pericellular 
spaces  together  with  the  latter  forming  the  actual  radicles  of  this 
set  of  vessels.  They  receive,  therefore,  the  surplus  plasma 
which  is  not  used  up  by  the  tissue  cells  in  performing  their 
trophic,  secretory  and  other  functions.  This  lymph  carried  on 
by  the  vis  a  tergo,  muscular  compression  and  other  movements,  is 
delayed  in  the  adenoid  tissue  known  as  lymph  nodes,  and  espec- 
ially in  the  lymph  glands,  in  which  the  proliferation  of  lymph 
cells  is  mainly  carried  on.  Thus  the  lymph  cells  are  very  scarce 
in  the  lymph  radicles  of  the  connective  and  other  tissues,  and  are 
found  in  greater  numbers  after  passing  through  the  lymph  nodes, 
and  in  still  greater  after  passing  through  the  lymph  glands.  But 
the  increase  of  cells  is  also  in  inverse  ratio  with  the  rapidity  of 
the  circulation  of  the  lymph.  When  this  is  rapid  the  cells  are 
hurried  on  and  there  is  little  time  for  their  reproduction.  When 
slow  on  the  other  hand,  there  is  time  for  cell  growth  and  division 
in  the  glandular  detention  cavities,  and  the  ratio  of  cells  to  the 
plasma  is  materially  increased.  Consider  next  that  the  multi- 
plicity of  cells  determines  an  increase  of  the  fibrine  factors,  so 
that  the  more  cells  the  lymph  contains  there  is  the  more  material 
for  fibrine  (lyandois),  and  we  have  one  good  reason  why  under 
enforced  rest  the  overcharged  and  congested  gland  may  become 
the  seat  of  fibrinous  coagula  or  lymphatic  embolism.  Any  over- 
distension, toxic  element,  or  other  cause  of  disturbance,  which 
deranges  the  functions  of  the  cell  or  causes  its  rapid  multiplica- 
tion by  division — as  in  inflammation — at  once  sets  free  the  fibrine 
ferment  and  determines  the  coagulation.     In  the  disease  before 


Acute  Lymphangitis  of  Plethora  in  the  Horse.  389 

us  we  have  the  overfeeding  of  an  animal  having  a  strong  diges- 
tion, we  have  an  absolute  compulsory  inactivity,  with  a  suspen- 
sion to  a  large  extent  of  the  functions  of  nutrition,  sanguifica- 
tion, secretion,  and  elimination  ;  we  have  in  consequence  an  in- 
crease of  the  blood  pressure,  and  of  the  solids  of  the  blood  and 
of  the  plasma  of  the  lymph  ;  we  have  a  suspension  of  the  great 
motor  force  of  lymph  circulation,  namely,  the  muscular  contrac- 
tion, and  we  have  the  consequent  tardy  movement  of  the  lymph, 
the  great  increase  of  lymphocytes,  and  the  distension  and  en- 
gorgement of  the  lymph  glands.  As  soon  as  this  has  reached  a 
certain  stage  the  congestion  and  incipient  inflammation  of  the 
gland  determines  the  precipitation  of  fibrine,  the  obstruction  of 
the  gland,  and  of  the  entire  circulation  of  lymph  in  the  lower 
part  of  the  limb.  The  fever,  the  local  swelling,  and  the  subse- 
quent steps  follow,  as  a  matter  of  course.  This  view  is  sustained 
by  the  fact  that  incipient  cases  can  be  cured  by  muscular  move- 
ment alone.  The  rarity  of  the  disease  in  the  fore  limb  may  be 
ascribed  to  the  greater  force  of  the  vis  a  tergo,  the  lesser  height 
of  the  lymph  column,  and  the  stronger  action  of  the  aspiratory 
power  of  the  chest  on  the  lymphatic  vessels. 

In  addition  to  the  causes  mentioned  above  must  be  noted  the 
following  :  The  disease  is  an  affection  of  heavy  draft  horses,  in 
which  the  tissues  are  more  lax,  and  the  lymph  plexus  in  the  con- 
nective tissue  of  the  hind  limb  is  much  more  abundant.  It  is 
common  in  the  heavy  English,  Scotch  and  Belgian  draft  horses, 
and  rare  in  the  English  racer,  the  American  trotter,  and  in  the 
average  light  American  horse.  The  malady  is  most  frequent  in 
spring  and  autumn,  when  the  work  is  hardest  and  the  feeding 
most  abundant.  It  rarely  attacks  the  horse  in  steady  work,  but 
appears  after  an  idle  Sunday  spent  in  the  stable  ( Monday  morn- 
ing disease),  or  after  one  or  more  days  of  compulsory  idleness 
from  heavy  rains  or  other  cause.  The  damp  climate  of  western 
Europe  has  probably  an  exciting  influence,  as  it  has  in  producing 
the  lymphatic  constitution.  In  the  same  line  of  thought  Zundel 
says  that  many  cold  weather  attacks  would  be  prevented  by  clip- 
ping off  the  heavy  coat  which  keeps  the  entire  system  relaxed. 
In  some  cases  a  sudden  change  of  food,  and  in  others  musty  oats 
have  been  claimed  as  causes. 

Diagnosis.     Lymphangitis  is  distinguished  from  a  simple  drop- 


3go  Veterinary  Medicine. 

sy  of  the  limb  by  the  acute  fever,  the  great  local  tenderness 
especially  of  the  inguinal  glands,  and  by  the  tender  corded 
lymphatics  that  enter  these.  From  cutaneous  glanders  (farcy)  it 
is  diagnosed  by  the  more  acute  fever,  by  the  swelling  of  the  in- 
guinal glands  in  the  early  stage  of  the  disease,  followed  by  the 
swelling  of  the  lower  limb,  and  by  the  absence  of  the  hard,  com- 
paratively insensible  and  prone  to  ulcerate,  farcy  bud.  Farcy 
buds  usually  appear  on  the  pastern  or  fetlock,  with  more  or  le.ss 
swelling  of  the  lower  part  of  the  limb,  while  the  inguinal  glands 
are  as  yet  normal  in  size  and  without  tenderness.  From  erysip- 
elas, with  which  this  has  been  confounded,  it  is  distinguished,  by 
the  suddenness  of  the  onset,  under  the  circumstances  above  de- 
scribed, by  the  high  type  of  fever,  by  absence  of  early  cutaneous 
inflammation  and  the  formation  of  vesicles,  and  by  the  fact  that 
lymphangitis  commences  in  swelling  of  the  inguinal  glands. 

Treatment.  In  cases  that  are  seen  in  the  earliest  stages,  before 
the  leg  has  become  badly  swollen ,  recovery  will  u.sually  take  place 
under  active  exertion  continued  for  hours  at  a  time.  The  pump- 
ing action  inside  the  hoof  during  exercise,  and  the  alternate  com- 
pression and  relaxation  of  the  lymph  vessels  by  the  muscles,  tend 
to  establish  a  rapid  current  of  lymph,  to  break  up  coagula  and  to 
re-establish  a  healthy  condition.  Friction  from  below  upward  on 
the  lymphatic  vessels  and  swollen  limb  will  greatly  assist  in  this 
restoration.  Different  agents  are  employed,  such  as  camphorated 
spirits  or  oil,  iodine,  mercurial,  and  even  blistering  ointments. 
These  should  not  replace  exercise  when  this  is  possible. 

When  the  fever  has  set  in  suddenly  and  runs  very  high,  the 
abstraction  of  four  or  five  quarts  of  blood,  and  the  administration 
of  a  purgative  (8  drs.  aloes)  will  be  in  order.  In  cases  occurring 
in  the  same  stable  and  in  all  other  respects  apparently  identical, 
the  subjects  of  phlebotomy  recovered  without  any  permanent 
swelling  of  the  limb,  while  those  that  were  not  bled  recovered 
with  thickened  limb. 

In  cases  so  advanced  that  the  limb  cannot  be  used,  cold  irriga- 
tion, with  friction,  may  be  applied,  and  when  the  irrigation  is  in- 
termitted one  may  apply  some  astringent  (vinegar,  alum,  lead 
acetate) ,  or  an  iodine  lotion  followed  by  an  evenly  applied  bandage. 

The  purgative  should  be  followed  by  full  doses  of  diuretics 
(nitre,  bicarbonate  of  potash  or  soda,  colchicum,  iodide  of  potas- 
sium) until  fever  and  local  inflammation  have  subsided. 


Acute  Lymphangitis  of  Plethora  in  the  Horse.  391 

As  soon  as  the  patient  can  use  the  limb,  walking  exercise 
should  be  kept  up  for  several  hours  forenoon  and  afternoon. 

Throughout  the  disease  the  food  should  be  of  a  light  and  non- 
stimulating  variety.  When  appetite  returns  give  at  first  wheat 
bran,  or  roots,  or  sweet  grass  in  small  amount,  and  do  not  return 
to  a  grain  diet  until  fully  recovered  and  ready  to  go  to  work. 

After  one  attack  there  is  always  an  increased  liability  to  a  second, 
and  great  care  should  be  taken  to  give  the  subject  daily  exercise, 
or  where  this  is  impossible,  to  reduce  the  feed,  give  a  dose  of 
saltpeter,  and  turn  into  a  yard  or  roomy  loose  box  on  the  idle  day. 

In  chronic  thickening  of  the  limb,  an  evenly  applied  elastic 
bandage,  extending  from  the  hoof  up,  regular  feeding  and  exer- 
cise, washing  daily  with  a  weak  iodine  lotion,  and  the  internal 
use  of  iodide  of  potassium  and  other  diuretics,  with  bitters  and 
even  iron  tonics  may  be  used. 


INFECTIVE     LYMPHANGITIS.      TRAUMATIC 
LYMPHANGITIS. 

Infection  varied,  through  wounds,  autogenous.  Simple  irritation,  sim- 
ple lymphangitis.  Causes,  sun's  rays,  bruises,  other  injuries,  lymph  co- 
agulation from  heat,  cold,  chemical  irritants,  and  coagulants.  Germs  in 
blood  act  on  debilitated  tissues,  lymphatic  constitutions,  ansemic,  over- 
worked, or  starved.  Insect  bites,  claws,  teeth  of  carnivora,  foul  instruments, 
fingers  or  clothes.  Bloodless  wounds  dangerous.  Distal  parts  of  the  limbs 
exposed.  Fresh  wound  exposed,  granulating  less  so.  Most  microbes  enter 
by  the  lymphatics.  Symptoms,  extension  from  wound,  swollen  lympha- 
tics,.reticular  lymphangitis,  tubular  lymphangitis,  farcy,  tuberculous  case, 
slough.  Fever  variable.  General  infection.  Joint  infection.  Chronic 
cases.  Lesions.  Diagnosis,  from  phlebitis.  Treatment,  antiseptics,  diet, 
eliminants,  antithermics,  blisters,  mercurial  ointment,  iodine,  lancing, 
tonics,  massage,  bandage. 

Under  this  heading  must  be  named  not  one  specific  disease  but 
a  group  of  infections  entering  by  the  lymphatic  vessels  and  de- 
veloping inflammation  of  their  substance.  They  may  be  divided 
into  two  classes :  those  caused  by  infection  through  external 
wounds  and  those  in  which  the  poison  already  in  the  system  be- 
comes localized  on  a  weak  or  exposed  tissue. 

A  third  class  must  be  included,  in  which  there  is  no  recogniza- 
ble poison  but  simply  a  local  irritation  which  leads  to  coagulation 
or  other  alteration  in  the  lymph,  or  disease  of  the  lymphatic 
vessels. 

This  subject  belongs  rather  to  surgery  than  medicine  but  it 
seems  necessary  to  contrast  it  here  with  the  plethoric  form  of 
equine  lymphangitis.  Most  of  its  forms  pertain  to  infectious  dis- 
eases and  will  be  treated  in  connection  with  these. 

Causes  of  Simple  Lymphangitis.  Formerly  many  forms  of 
lymphangitis  were  ascribed  to  mere  local  irritation  ;  a  superficial 
form  will  occur  from  exposure  to  the  rays  of  the  sun,  and  an  in- 
flammation attendant  on  a  bruise  or  other  injury  with  unbroken 
skin,  may  cause  local  inflammation  of  the  lymph  vessels  and  en- 
largement of  the  adjacent  lymph  glands.  As  we  have  seen  above 
coagulation  of  the  lymph  and  fibrine  embolism  may  induce  local 
inflammation  in  the  walls,  and  this  may  occur  in  connection  with 
392 


Infective  Lymphangitis.      Traiiniatic  Ly^nphangieis.        393 

excessive  heat  or  cold  or  the  presence  of  chemical  irritants  and 
coagulants.  These  cases  are  however  rarely  serious  and  the  ten- 
dency to-day  is  to  trace  nearly  all  cases  to  infection,  from  germs 
already  present  in  the  lymph  or  blood,  or  introduced  through  a 
wound  cr  sore.  The  effect  of  germs  already  circulating  was 
shown  in  the  beautiful  demonstrations  of  Chauveau  in  regard  to 
calves  subjected  to  castration  by  subcutaneous  torsion  (bistourn- 
age).  In  the  healthy  calf  the  simple  operation  gave  rise  to  little 
disturbance.  The  healthy  calf  injected  with  septic  liquids  equally 
escaped  visible  trouble.  But  the  calf  injected  with  septic  liquids 
and  then  subjected  to  bistournage  had  a  fatal  infecting  inflamma- 
tion. There  is  a  strong  presumption  that,  in  lymphangitis,  start- 
ing from  an  injury  with  no  external  sore,  the  germs  were  already 
present  in  the  blood  or  tissues  but  were  unable  to  do  any  serious 
damage  until  the  injured  and  weakened  part  or  organ  offered  an 
area  of  lessened  resistance  to  their  colonization.  Following  the 
same  line  of  thought  it  has  been  noticed  that  animals  of  a  coarse 
texture,  and  lymphatic  constitution  (heavy  draft  horses  and  ani- 
mals raised  for  the  butcher),  and  such  as  are  debilitated  by 
anaemia,  overwork,  or  poor  and  insufficient  nourishment  are  above 
all  liable  to  be  attacked  by  lymphangitis. 

The  insertion  of  the  septic  poison  may  take  place  through  the 
bites  of  insects,  the  claws,  or  teeth  of  carnivora  that  have  been 
devouring  tainted  or  infecting  meat,  through  the  lancet  or  operat- 
ing instrument  of  the  surgeon,  by  his  fingers  or  the  dust  from  his 
hair  or  clothes.  The  wound  is  perhaps  more  likely  to  be  infect- 
ing if  it  leads  to  no  effusion  of  blood,  but  affects  only  the  thick- 
ness of  the  epidermis,  as  there  is  less  chance  for  the  washing  out 
of  germs  by  the  flowing  blood,  and  there  is  less  care  to  employ 
antiseptics.  Wounds  in  the  feet  and  lower  parts  of  the  limbs  are 
speciall}^  liable  to  infection  by  reason  of  their  frequent  contact 
with  manure  and  decomposing  organic  matter  in  the  soil. 

A  fresh  wound,  in  which  the  lymph  spaces  are  exposed,  is  some- 
what more  open  to  infection  than  one  that  has  advanced  to  the 
stage  of  granulation,  the  layer  of  unorganized  lymph  and  cells 
acting  as  a  slight  barrier  to  the  passage  of  the  microbes. 

Nearly  all  microbian  diseases  make  their  inroad  by  way  of  the 
lymphatics,  where  the  sparse  cells  fail  to  establish  as  active  phago- 
cytosis as  do  the  numerous  moving  cells  of  the  blood.     Hence  a 


394  Veterinary  Medicine. 

number  of  infectious  maladies  are  primarily-  and  pre-eminently 
diseases  of  the  lymphatics,  as  glanders,  strangles,  tuberculosis, 
cancer,  anthrax,  swineplague,  etc. 

Symptoms.  The  most  common  form  is  where  lymphangitis  ex- 
tends from  some  pre-existing  wound — as  pricked  or  suppurating 
foot,  fistula  of  foot,  withers  or  poll,  chafing  of  shoulder  or  back, 
cracked  heels,  boil,  sloughing  bruise,  etc.  The  swelling  around 
the  sore  or  injury  involves  in  fact  the  radical  lymphatic  plexus  in 
the  connective  tissue  (reticular  lymphangitis).  When  the  swell- 
ing extends  and  becomes  more  tense,  with  firm,  painful  sinuous 
cords  running  out  of  it  in  different  directions,  and  especially  to- 
ward the  nearest  lymphatic  glands,  and  when  these  glands  are 
slightly  swollen  and  tender,  tubular  lymphangitis  is  diagnosed. 
No  more  striking  example  can  be  found  than  in  skin  glanders 
(farcy).  The  rigid  cords  extend  from  the  side  of  the  face,  from 
the  eye,  and  nose  down  toward  the  submaxillary  glands  and  with 
more  or  less  adjacent  engorgement.  Or  on  a  hind  limb,  or  some 
portion  of  the  trunk,  a  more  or  less  turgid  swelling  with  one  or 
more  firm  nodes  (farcy  buds)  and  painful,  tortuous  cords  running 
towards  the  lymph  glands  is  very  characteristic. 

A  tuberculous  case  may  show  an  indolent,  hard,  comparatively 
insensible  cutaneous  cord  leading  toward  the  jugular  furrow,  the 
prescapular,  precrural  or  inguinal  glands,  and  at  long  intervals 
softening,  fluctuating,  bursting  and  discharging  a  thick  pus.  In 
a  carcinoma  there  is  the  old,  hard,  nodular,  and  finally  ulcerating 
swelling  from  which  the  firm  cords  extend  to  the  mass  of  steadily 
enlarging  lymphatic  glands. 

A  simpler  form  is  where  a  bruise  by  the  harness  causes  a  hard, 
thick,  slough,  embracing  the  entire  thickness  of  the  skin,  from 
which  the  firm  corded  lymphatics  extend  in  different  directions. 
After  the  slow  process  of  detachment,  the  local  lymphangitis 
usually  subsides  under  simple  cooling  or  antiseptic  treatment. 

But  the  grade  of  such  lymphangitis  is  as  varied  as  the  particu- 
lar germ  or  combination  of  germs  present  in  the  wound,  and  the 
susceptibility  of  the  animal  attacked,  and  there  will  be  high, 
moderate  or  no  fever,  according  to  the  severitj^  of  the  case,  and 
in  some  cases  purely  local  trouble  and  in  others  general  infection 
with  purulent  or  septic  localization  in  distant  parts.  There  is  al- 
ways danger  of  extension  to  a  neighboring  joint  with  destructive 
results. 


bifedive  Lymphangitis.      Traumatic  Lymphangitis.        395 

A  curious  outbreak  is  described  by  Wiart  as  attacking  nearly 
every  horse  in  the  regiment  that  sustained  a  slight  wound.  A 
tubercle  looking  mass  formed  in  the  depth  of  the  wound  was  slow 
to  heal,  and  the  lymphatics  leading  out  from  it  became  round, 
corded,  turgid,  and  at  long  intervals  developed  along  their  course 
fluctuating  centres  which,  whether  opened  spontaneously  or  by 
the  lancet,  showed  the  same  indolent  habit.  A  single  attack 
would  last  from  two  to  six  months,  and  the  actual  cautery  had  to 
be  used  on  the  sores. 

The  lesions  are  those  already  described  in  the  last  article  for 
simple  lymphangitis.  For  infecting  cases  they  are  those  of  the 
particular  disease  which  may  be  present. 

Diagnosis.  The  general  diagnosis  of  lymphangitis  is  the  dis- 
tinction from  phlebitis.  In  phlebitis  the  vein  is  blocked  and  can- 
not be  raised  by  pressure  on  the  side  leading  toward  the  heart  ; 
in  lymphangitis  it  can  be  so  raised.  The  swelling  and  tenderness 
are  both  greater  in  lymphangitis.  The  inflamed  vein  is  more 
rectilinear,  the  lymph  vessel  somewhat  sinuous.  If  suppuration 
ensues  it  is  more  diffuse  in  lymphangitis  ;  more  restricted  and 
mixed  with  the  elements  of  blood  in  phlebitis. 

For  identification  of  the  particular  forms  of  infecting  lymphan- 
gitis, the  reference  must  be  made  to  the  individual  infectious 
diseases. 

Treatment.  In  general  the  treatment  of  lymphangitis  is  the 
antisepsis  of  wounds.  Further  than  this  the  treatment  of  each 
case  is  that  of  the  particular  disease  which  it  represents.  For  all 
cases  alike  it  is  important  to  apply  vigorous  treatment  early,  so  as 
to  cut  it  .short  bafore  it  can  attain  a  dangerous  extension. 

For  the  simpler  forms  of  lymphangitis  the  wound  should  first 
be  thoroughly  cleansed  and  disinfected.  Washing  with  .soap  suds, 
or  carbonate  of  soda  will  remove  any  greasy  agent  which  would 
prevent  a  thorough  antisepsis.  Then  it  may  be  washed  with  the 
antiseptic  lotion  : — carbolic  acid  solution  (1:20),  or  mercuric  chlo- 
ride solution  (1:500),  or  zinc  chloride  (1:400)  or  potassium  per- 
manganate (1:160).  If  the  infection  has  been  introduced  by  a 
small  or  punctured  wound,  the  sting  or  bite  of  an  insect,  or  the 
prick  of  a  sharp  instrument  it  .should  be  freely  cauterized  to  its 
depth  with  lunar  caustic  incising  it  if  need  be  to  reach  the  whole 
of  the  poison,  and  the  surface  afterward  dressed  with  antiseptics. 


396  Veterinary  Medicine. 

The  diet  should  be  light  but  nutritious  and  laxative,  and  the 
free  action  of  the  bowels  and  kidneys  should  be  maintained  by 
salines.  When  fever  runs  high  give  quinine,  or  salicylate  of  soda. 
When  a  large  wound  has  to  be  dressed  it  may  be  requisite  to 
use  a  non-poisonous  agent  like  acetate  of  aluminium  or  boric  acid 
to  irrigate  it  thoroughly.  In  some  such  cases  packing  the  irri- 
gated wound  with  iodoform  gauze  has  often  an  excellent  effect. 

When  there  is  a  firm  inflamed  cord,  hot  and  painful,  a  fly  blister 
along  its  course  followed  by  mercurial  ointment  often  gives  excel- 
lent results.  Or  they  may  be  repeatedly  painted  with  tincture  of 
iodine. 

Foci  of  suppuration  must  be  promptly  opened  and  thoroughly 
and  persistently  disinfected. 

With  suppuration  in  multiple  abscesses  or  large  open  sores 
liberal  feeding  must  be  enjoined  and  iron  and  other  tonics  should 
be  resorted  to. 

The  persistent  swelling  of  the  part  must  be  met  by  active  rub- 
bing or  kneading,  b};-  exercise  and  by  uniform  compression  by  a 
flannel  or  elastic  bandage. 


LYMPHANGIECTASIS.     DILATED  LYMPHATICS. 

Result  of  lyiiipliangitis,  of  heart  disease,  of  pulmonary  arterial  thrombo- 
sis, of  external  jugular  plugging.  Causes,  obstruction  to  lymph  flow,  com- 
pression, increased  venous  blood  pressure,  fibrinous  lymph  coagula,  action 
of  sensory  nerves,  of  lymphadenitis,  anaemia.  Symptoms  like  dropsy  if 
in  plexus,  in  large  lymphatics,  moniliform  swelling,  sacculation,  wounds 
discharge  lymph,  hyperplasia  of  connective  tissue,  fatty  deposits,  lipoma- 
ta.  Treatment,  elastic  bandage,  cold,  astringents,  iodine,  punctures,  liga- 
tures, cauterizations,  tonics. 

The  most  striking  cases  of  dilatation  of  the  lymphatics  in  the 
lower  animals  are  met  with  in  horses  that  have  suffered  repeatedly 
and  severely  from  the  lymphangitis  of  plethora.  Then  the  lower 
part  of  the  shank  and  the  postern  are  enormously  thickened  to 
perhaps  two  or  even  three  feet  in  circumference,  and  skin  and 
connective  tissue  are  the  seat  of  a  general  dilatation  of  the  lym- 
phatic plexus  and  vessels  with  great  thickening  of  their  walls. 
Nocard  and  Barrier  record  cases  of  general  dilatation  of  the  lym- 
phatics in  dogs  in  connection  with  heart  disease,  al.so  the  case  of  a 
horse  with  old  standing  thrombosis  of  the  pulmonary  arteries, 
hypertrophy  of  the  right  heart,  and  dilatation  of  the  thoracic  duct 
to  the  size  of  the  arm  and  of  the  lymphatics  of  the  mesocolon  to 
the  diameter  of  half  an  inch  to  nearly  an  inch.  Nocard  records 
two  cases  in  the  horse,  one  of  a  reticular  lymphangioma  of  the 
sheath,  and  the  other  of  dilatation  of  the  lymph  vessels  accompa- 
nying the  saphena  vein  on  the  inside  of  the  thigh.  This  formed 
small,  soft,  fluctuating,  extremely  irregular  tumors,  completely 
covering  the  vein  for  a  space  of  about  four  inches. 

In  both  cases  the  dilatations  were  surrounded  by  a  thick  layer 
of  connective  tissue  filled  with  liquid-.  Virchow  records  a  case  of 
a  new-born  calf  in  which  a  thrombosis  of  the  external  jugular 
vein  caused  obstruction  of  the  mouth  of  the  thoracic  duct,  and  a 
consequent  extreme  disten.sion  of  all  the  splanchnic  lymph  ves- 
sels with  a  slightly  sanguinolent  fluid.  The  intestines  especially 
were  covered  everywhere  with  broad,  bead-like  canals,  arranged 
so  closely  together  that  the  intervening  tis.sue  could  be  scarcely 
recognized. 

397 


398  Veterinary  Medicine. 

The  causes  of  lyniphangiectasis  appear  to  be  generally  some  ob- 
struction to  the  onward  flow  of  the  lymph.  Any  diseased  condi- 
tion, therefore,  that  causes  compression  of  the  larger  lymph 
vessels  may  cause  dilatation  of  the  smaller  ones  leading  into  these. 
General  distension  may  come  from  disease  of  the  lungs  or  left 
heart  and  increased  venous  blood  pressure,  or  from  thrombus  of 
the  jugular,  or  a  tumor  obstructing  the  thoracic  duct,  while  local 
engorgments  may  come  from  the  pressure  of  tumors,  or  the  oc- 
currence of  lymphangitis  and  formation  of  fibrinous  coagula.  In 
cases  of  partial  obstruction  of  the  lymph  vessels  the  increased 
secretion  of  lymph  ma}^  lead  to  distension  and  enlargement.  It 
may  be  named  in  this  connection  that  irritation  of  the  sensory 
nerves  in  dogs  has  been  shown  to  determine  a  larger  production 
of  lymph  (Krause).  lyymphadenitis  and  the  obstruction  of  the 
passage  of  lymph  through  the  glands  is  an  obvious  cause,  and 
hence  the  disease  is  specially  liable  to  appear  in  connection  with 
diseases  which  show  a  predilection  for  the  lymphatics  (tuberculo- 
sis, glanders,  strangles,  carcinoma,  etc.) 

In  his  work  on  dilatation  and  occlusion  of  lymph  channels 
Busey  shows  that  in  man  the  majority  of  cases  are  in  hospital  pa- 
tients in  whom  blood  and  general  health  hav^e  been  impoverished 
and  reduced  by  unhygenic  conditions.  One  case  gave  support  to 
the  theory  of  maternal  impression,  the  pregnant  mother  having 
suffered  from  over-use  of  the  right  limb  on  a  sewing  machine, 
and  the  offspring  having  shown  extensive  lyniphangiectasis  in 
the  right  leg. 

Symptoms  consist  in  enlargement  of  the  lymph  vessels  or 
plexus,  and  often  of  the  glands.  If  of  the  lymph  plexus  it  may 
appear  like  a  dropsical  effusion  in  the  part,  with  or  without  saccu- 
lar dilatations  at  intervals.  If  of  the  larger  ves.sels,  their  tor- 
tuous ana.stomosing  trunks  following  largely  the  lines  of  the  veins 
are  usually  characteristic.  If  the  distension  is  slight  it  is  usually 
moniliform,  as  the  valves  are  still  intact,  and  the  intervals  be- 
tween them  stand  out  as  bladder-like  masses.  If  the  structure  is 
wounded  or  if  it  ulcerates  there  is  the  discharge  of  a  straw-col- 
ored fluid,  often  rendered  milky  by  the  presence  of  fatty  granules, 
and  at  times  tinged  with  blood.  There  is  always  a  tendency  to 
the  increase  and  condensation  of  the  connective  tissue  surround- 
ing the  ves.sels,  and  fatty  degeneration  and  the  formation  of  lipo- 
mata  are  not  uncommon. 


Lyviphorrhiva.     Lymphorrhagia.  399 

Treatment.  Compression,  by  flannel  or  elastic  bandage,  from 
the  foot  upward,  is  the  simplest  and  most  promising  treatment 
when  the  limb  is  affected.  The  local  application  of  cold,  astrin- 
gents or  iodine  may  be  added.  Punctures,  ligatures,  and  cauter- 
ization have  not  given  encouraging  results.  lyigature  of  the  nu- 
trient artery  of  the  part,  has  succeeded  in  one  or  two  cases,  but 
has  failed  in  others.  Tonics  are  to  be  tried  more  particularly  in 
cases  due  to  specific  debilitating  diseases.  Sometimes  a  sponta- 
neous recovery  has  been  noticed  when  the  surrounding  connective 
tissue  has  increased  and  contracted  in  connection  with  inflamma- 
tion. 


LYMPHORRHCEA.      LYMPHORRHAGIA.       DISCHARGE 
OF  I.YMPH  THROUGH  WOUNDS  OR  SORES. 

Result  of  rupture  of  liimpliatics.  Milky,  fatty  lymph.  Treatment,  liga- 
ture, excision,  cauterizatioa,  of  little  avail.     Compression.     Tonics. 

Obstruction  of  a  lymph  duct  may  lead  to  rupture  and  the  dis- 
charge of  its  fluid  on  the  surface  or  into  an  internal  cavity.  Dr. 
Cayley  records  a  case  of  fatal  peritonitis  in  man  from  rupture  of 
the  receptaculum  chyli,  and  the  formation  of  lymph  fistulse  has 
been  attributed  to  filaria  sanguinis  hominis.  We  are  aware  of  no 
corresponding  case  in  connection  with  the  blood  parasites  of  the 
horse  or  dog.  In  the  larger  domestic  animals  the  great  thickness 
and  resistance  of  the  skin  offers  a  barrier  to  the  rupture  of  sub- 
cutaneous lymph  vessels,  but  this  no  longer  applies  in  case  of  a 
suppurating  or  ulcerous  wound.  The  escaping  lymph  has  often 
a  milky  hue  from  the  admixture  of  fat,  jnst  as  its  escape  in  the 
kidneys  causes  chyluria,  and  in  the  bowel  fatty  stools.  The 
escape  is  often  very  profuse  and  persistent,  and  results  in  marked 
debility.  Ligature  and  excision  of  the  fistulous  vessel,  also 
cau.stics— actual  and  potential,  have  been  tried  with  rather  poor 
success.  Fitzer  succeeded  in  an  obstinate  case  by  the  extensive 
application  of  nitrate  of  silver  and  others  by  simple  compression. 
As  the  victims  are  usually  debilitated  a  course  of  tonics  is 
usually  desirable. 


LYMPHADKNITIS.     INFLAMMATION  OF  THE  LYMPH 
GLANDS. 

Result  of  lesions  of  tributary  tissues.  Arrest  in  glands  of  microbes  and 
other  irritants.  Trauma  of  gland.  Inflammation.  Symptoms,  swelling, 
stiffness,  gland  tender,  hot,  pitting  envelope,  corded  lymph  vessels,  abscess, 
fever.  L,esions.  Treatment,  antiseptics,  astringents,  emollients,  vesicants, 
lancing,  antiseptics,  antiphlogistics,  antitliermics.  Chronic  adenitis. 
Symptoms,  enlarged  glands  without  engorgement,  if  simple  affects  a  single 
gland,  if  infectious,  a  group.  Lesions,  gland  swelling,  induration,  shrink- 
ing, follicular  distension,  pigmentation,  growth  of  lymphocytes,  caseation, 
calcification.  Treatment,  antiphlogistic,  antiseptic,  iodine,  chloride  of 
calcium,  iodide  of  potassium. 

Apart  from  traumatic  lesions  lymphadenitis  virtually  implies 
some  lesion  of  the  tissues  from  which  the  different  vessels  of  the 
glands  proceed.  The  glands  however  have  been  referred  to  as 
filtering  agents  on  the  course  of  the  lymph  vessels  and  in  this 
partial  view  of  their  functions  we  find  abundant  reason  why  irri- 
tants carried  in  the  lymph  stream,  should  be  arrested  with  patho- 
genic results  in  the  glands.  A  particle  of  pigment  gaining  en- 
trance to  the  lymph  vessels  tends  to  be  arrested  among  the  trabeculse 
of  the  gland,  and  contributes  to  the  pigmentation  so  common  in 
old  animals.  Cells  and  granules  from  malignant  tumors,  and 
bacteria  from  an  infection-atrium  are  arrested  in  the  glands  and 
make  these  the  great  centres  of  infection-lesions. 

Trattmatic  inflammation  comes  from  bruises,  punctures  or  in- 
cisions directly  implicating  the  glands.  There  result  swelling, 
tenderness  and  the  other  general  signs  of  inflammation,  and  in 
the  case  of  an  open  wound  possibly  lymphorrhagia. 

Acute  inJiammatio7i  more  commonly  supervenes  on  inflamma- 
tion in  the  area  drawn  upon  by  the  afferent  ves.sels  of  the  gland. 
In  inflammations  generally  the  adjacent  lymphatic  glands  become 
congested.  In  lymphangitis  it  is  so  in  a  marked  degree.  In  ex- 
ternal parts  we  can  follow  this  by  careful  observations  during  life, 
in  internal  organs  we  often  find  the  glandular  enlargement  after 
death. 

Symptoms  consist  in  swelling  and  perhaps  stiffness  in  the  re- 
gion of  the  gland.  Manipulation  shows  tenderness  and  heat,  the 
gland  being  felt  abnormally  large,  round,  or  oval,  tense,  loose 
400 


Lyi/iphadoiitis.     InjJaiiiniation  of  the  Lymph  Glands.      401 

from  \.\\z  skin  but  liaving  a  distinct  envelope  of  soft  pitting  exu- 
date which  tends  to  increase  in  a  downward  direction.  There 
may  or  may  not  be  a  corded  feeling  of  the  afferent  lymphatic 
trunks.  As  the  pasty  swelling  increases,  it  extends  into  sur- 
rounding parts,  binds  the  gland  to  the  skin  and  adjacent  .struc- 
tures, and  may  even  conceal  the  gland  in  the  excess  of  its  invest- 
ing engorgement.  This  is  especially  frequent  in  strangles.  As 
the  process  advances  softening  may  take  place  in  the  centre  and 
extend  toward  the  circumference,  and  this  may  burst  like  an 
ordinary  abscess.  In  some  cases  the  softening  is  very  limited 
and  tardy,  and  the  pus  may  be  pent  up  and  inspissated,  or  it 
may  appear  to  be  entirely  reabsorbed  while  the  gland  is  in  pro- 
cess of  induration.  Fever  which  may  run  high  during  the  pro- 
cess of  suppuration,  moderates  when  that  has  been  accomplished. 

In  the  case  of  glands  too  deeply  situated  to  be  clearly  felt  the 
occurrence  of  purulent  fluctuation  in  their  vicinity  suggests  abscess. 
of  the  glands,  an  important  induction  as  the  maturation  and 
healing  are  usually  slow  in  the  gland  tissue. 

Lesions.  At  the  outset  the  glands  are  visibly  enlarged,  softened, 
and  of  a  dark  red  hue,  with  spots  of  a  brighter  red.  The 
changes,  mainly  in  the  medullary  layer,  consist  in  a  great  pro- 
liferation of  spheroidal  cells  in  the  follicles  and  also  of  polyhediral; 
cells  in  the  lymph  sinuses.  The  endothelial  cells  are  swollen,,, 
the  blood  vessels  gorged,  and  extravasations  of  blood  into  the^ 
follicles  and  sinuses  are  frequent.  Abscess  or  fibroid  hyperplasia 
with  induration  may  follow.  Much  depends  on  the  particular 
infection  (tuberculosis,  glanders,  carcinoma,  etc.)  as  the  special 
product  of  each  disease  will  be  found  in  the  affected  gland. 

Treatment  is  in  the  main  as  advised  for  lymphangitis  and  will 
vary  with  each  specific  causative  disease.  Locally  antiseptics,, 
astringents,  deobstruents,  emollients,  and  vesicants  will  be 
requisite  in  different  cases.  As  soon  as  pus  can  be  distinctly 
diagnosed  it  should  as  a  rule  be  evacuated,  and  the  cavity  treated 
antiseptically.  General  treatment  may  at  first  be  antiphlogistic 
and  febrifuge,  but  must  usually  embrace  tonics  and  stimulants  in 
the  end. 

Chronic  Adenitis  may  be  a  sequel  of  the  acute,  or  it  ma}- 
arise  independently.  In  the  latter  case  it  is  u.sually  the  result  of 
some  other  disease  (tuberculosis,  glanders,  carcinoma,  sarcoma 
26 


402  Veterinary  Medicine. 

melanosis  inveterate  disease  of  the  skin,  chronic  fistula,  abscess, 
or  mucous  inflammation). 

The  symptoms  are  those  of  enlarged  glands  with  no  material 
surrounding  engorgement.  In  the  infections  of  tuberculosis  and 
glanders  it  shows  a  tendency  to  affect  the  whole  group,  whereas 
in  simple  abscess  or  in  suppuration  of  the  nasal  sinuses  it  may  im- 
plicate one  gland  only,  the  remainder  appearing  normal. 

Lesions.  The  gland  often  becomes  indurated  and  even 
shrunken,  the  connective  tissue  elements  undergoing  a  steady  in- 
crease at  the  expense  of  the  follicles  and  lymphoid  cells.  This  is 
a  common  condition  of  tuberculous  glands  (perl-knoten,  grapes) 
of  cattle,  but  may  result  from  the  entrance  of  pigment  or  other 
cau.se  of  mild  irritation.  In  other  cases  pigment  entering  from 
without  or  developed  from  blood  in  the  congested  gland,  finds 
permanent  lodgment  in  its  tissue  and  may  give  it  a  gray  mottled 
or  quite  black  aspect.  In  still  other  cases,  there  is  a  great  in- 
crease of  the  round  lymphoid  and  larger  polyhedral  cells,  many 
of  which  degenerate  becoming  strongly  refracting,  stain  feebly, 
or  not  at  all,  and  pass  into  a  cheesy  degeneration.  This  is  a  com- 
mon condition  in  tuberculosis  and  glanders,  and  the  caseous  cen- 
tres beginning  as  multiple  miliary  centres  may  coalesce  to  form 
masses  of  six  or  twelve  inches  in  their  greatest  diameter  as  in  bo- 
vine tuberculosis.  In  other  cases  the  caseating  mass  becomes  the 
.seat  of  calcareous  deposit  and  the  necrotic  and  caseated  gland  be- 
comes in  part  calcified.  Other  degenerative  changes  such  as 
atrophy,  amyloid,  and  hyaline  are  met  with  but  have  received 
little  attention. 

Treatment  will  be  subordinated  to  the  primary  cause.  If  that 
is  a  simple  local  inflammation  or  irritation  its  removal  will  entail 
a  speedy  improvement  in  the  gland,  and,  in  the  absence  of  too 
extensive  structural  change,  a  speedy  recovery.  The  infectious 
cases  on  the  other  hand  are  likely  to  prove  as  inveterate  as  the 
disease  on  which  they  depend.  In  case  the  enlargement  or  con- 
gestion of  the  gland  persists  after  the  removal  of  its  primary 
cause  local  deobstruants  especially  the  preparations  of  iodine 
are  usually  effective.  Tincture  of  iodine  with  soap,  iodide  of 
lead,  and  mercurial  ointment  have  been  severally  used  with  ad- 
vantage. Injection  of  a  weak  solution  of  iodine  into  the  gland 
will  at  times  succeed.  The  internal  use  of  chloride  of  calcium  or 
iodide  of  potassium  will  often  hasten  recovery. 


INDEX. 


Abomasum,  position  of  in  ox,  156. 
Abscess  in   adynamic  inflammation,  I 

71.  I 

Abscess  of  false  nostril,  92,  97. 
Abscess  of  guttural  pouches,  94. 
Abscess  in  heart,  33S,  341. 
Abscess  in  inflammation,  71. 
Abscess  of  the  lung  in  pneumonia,  1 

225. 
Actinomycosis,  99. 
Adynamic  fever,  68. 
Adynamic  inflammation,  68. 
Adynamic  inflammation,  abscess  in, 

7^-        .      . 

Adynamic  inflammation,  blistering 
in,  70. 

Adynamic  inflammation,  firing  in,  70. 

Adynamic  inflammation,  massage  in, 
71-        .    . 

Adynamic  inflammation,  suppuration 
in,  71. 

Adynamic  inflammation,  local  treat- 
ment of,  69. 

Adynamic  inflammation,  treatment 
of.  68. 

Adynamic  fever,  treatment  of,  68. 

Air,  character  of  the  expired,  353. 

Air,  eff"ects  of  vitiated,  ]8o. 

Air  in  the  pleura,  265. 

Air  passages,  parasites  of,  290. 

Anaemia,  chronic,  377. 

Ansemia,  idiopathic,  375. 

Aiiseniia  oligaemia,  371. 

Aucemia,  pernicious,  375. 

Anaemia,  progressive  pernicious,  375. 

Anamnesis,  19. 

Anatomy,  definition  of  pathological,  2. 


Anetirism 


)6,  359 


Aneurism  by  anastomoses  359. 
Angeioleucitis,  386. 
Angeioma,  359. 
Angina,  1 14. 
Angina  pectoris,  311. 
Angina  pharyngea,  126. 
Angioma  in  nose,  100. 
Apoplex}-,  pulmonarj',  21  r. 
Arterieclasis.  356. 
Arteries,  diseases  of,  345. 
Arterio-sclerosis,  359. 
Arteritis,  345. 
Arteritis,  external,  345. 


Arteritis,  internal,  345. 
Asthma,  274. 

Asthma  in  the  dog,  bronchial,  270. 
Asthma  in  the  horse,  273. 
Asthma,  pathology  of,  270. 
Asthma,  symptoms  of,  271. 
Asthma,  treatment  of,  271. 
Atelectasis,  206. 
Atelectasis,  causes  of,  206. 
Atelectasis,  lesions  of,  207. 
Atelectasis,  symptoms  of,  207. 
Atelectasis,  treatment  of,  208. 
Atheroma,  349. 
Atrophy,  322 
Auscultation,  164. 
Auscultation  of  birds,  168. 
Auscultalion  of  cough,  174. 
Auscultation  of  dog,  168. 
Auscultation  of  goat,  168. 
Auscultation  of  horse,  166. 
Auscultation,  immediate.  164. 
Auscultation,  mediate,  164. 
Auscultation  of  ox,  167. 
Auscultation  of  pig,  168. 
Auscultalion  of  sheep.  168. 
Axillary  arter}-,  embolism  of,  355. 

Bacili.us  of  Friedlander,  216. 

Bacteriology  of  pneumonia,  216. 

Baths,  cold,  65. 

Baths,  warm,  64. 

Birds,  auscultation  of,  168. 

Birds,  percussion  in.  161. 

Bleeding,  in  fever,  63. 

Bleeding,  local.  64. 

Blistering  in  inflammation,  70. 

Blood,  active  determination  of,  33. 

Blood,  arterial  determination,  33. 

Blood,  black  pigment  in,  378. 

Blood,  diseases  of,  367. 

Blood  exudations,  52. 

Blood  globules,  367. 

Blood-globules,  numbers  of,  36S. 

Blood,  modifications  of  in  pneumoni 

226. 
Blood,  ratio  to  body-weight,  370. 
Bot-fly,  sheep,  109. 
Bots,  149. 
Breast  pang.  311. 
Breathing,  deep,  154. 


404 


hide: 


Breathing,  hurried,  153. 

Breailiiiig,  labored,  154. 

Breathing  siippleiiieiitrtr}-,  169 

Breathing,  quick,  153. 

Broken  wind,  274. 

Broken-winded    horses,   examination 

of,   2S7 
P>ronchial  asthma  in  the  dog,  270. 
Bronchial  catarrh,  191. 
Bronchial  glands,  diseases  of,  290. 
Bronchial  sound,  170. 
Bronchial  tubes,  polypus  of,  289. 
Bronchitis,  178. 

Bronchitis,  acute  in  horse,  178. 
Bronchitis,  capillary,  186. 
Bronchiiis,  chronic  in  horse,  191. 
Bronchitis,  in  cattle,  197. 
Bronchitis  in  dog,  193. 
Bronchitis  in  ox,  193 
Bronchiiis  iu  sheep,  197 
Bronchitis,  pseudo-nienibranous,  186 
Bro'icho  pleiiro  pneumonia,   258. 
Broncho  pneumonia,  258 

Cadeac's    diplococcus     pneumonise 

equina,  218. 
Cancer  of  the  heart,  341. 
Carcinoma  in  nose,  99. 
Carditis,  338. 
Carious  Teeth,  Nasal  Discharge  from. 

Catarrh,  bronchial,  191. 

Catarrh,  chronic,  in  cattle,  104. 

Catarrh,  chronic  nasal,  87. 

Catarrh,  coccidian  in  rabbits,  108. 

Catarrh,  malignant,  105. 

Catarrh,  nasal  from  lin^uatula,  113. 

Catarrh,  nasal  from  rhiuaria  taeuio- 

ides,  1 13 
Catarrh,  nasal  in  dog,  113. 
Catarrh,  nasal  in  horse,  113 
Catarrh,  of  cattle,  105. 
Catarrh  of  frontal  sinuses  in  ox,  loi. 
Catarrh  of  nose,  81. 
Catarrh,  traumatic,  loi. 
Cattle,  catarrh  of,  105. 
Cattle,  chronic  catarrh  in,  104. 
Cattle,  Coryza  in,  85 
Cattle,  croupous  bronchitis  in,  197. 
Cattle,  pharyngo-laryhgitis  of,  122. 
Cattle,  pleurisy  in,  253. 
Cell  change,  42. 
Cell  proliferation,  42. 
Cephalemia  maculata,  112. 
Changes  in  circulation,  45. 
Changes  in  innervation,  44. 
Changes  in  tissue  elements,  41. 
Chemiotaxis,  47. 


Chemistry,  definition  of  pathological, 
I      2. 
I  Chest,  155 

Chest,  accidental  sounds  of,  167. 

Chest,  bronchial  sound  of,  165. 

Chest,  diseases  of,  150. 

Chest,  healthy  sounds  of,  165,  167. 

Chest,  mensuration  of,  175. 

Chest    sounds,    modifications    of 
healthy,  169. 

Chest,  morbid  sounds  of,  152. 

Cliest  percussion  of  in  horse,  159. 
,  Cliest,  percussion  of  in  ox,  159. 

Chest,  contents  of  in  horse,  155. 

Chest,  respiratory  murmur  of,  165. 

Chest  sounds,  abnormal,  171. 
I  Cliest  sounds,  amphoric,  171. 

Chest  sounds,  cavernous    171. 

Chest  sounds,  morbid,  169. 

Chest  sounds,  mucous,  171. 

Chest,  tapping  the,  261. 

Chest,  tubal  sound  of,  165. 

Chest,  vesicular  sound  of,  165. 

Chronic  pneumonia  in  the  ox,  235. 

Chyliform  exudate,  52. 

Circulation,  changes  in,  45. 

Circulation,  diseases  of  organs  of,  291. 

Clots  in  the  heart,  337. 

Cloudv  swelling,  41. 

Coccidian  catarrh  in  rabbits,  108. 

Cold,  action  of,  74. 
(  Cold  in  the  head,  81. 

Collapse  of  lung,  206. 
[  Collapse  of  lung,  causes  of,  206. 

Collapse  of  lung,  symptoms  of,  207. 

Collapse  of  lung,  treatment  of,  208. 

Congestion,  33. 

Congestion  of  the  lungs,  198. 

Congestion   of  the  lungs,   causes  of, 
198. 

Congestion   of    the  lungs,  course  of, 
201. 

Congestion   of  the  lungs,  lesions  in, 
201. 

Congestion   of  the  lungs,    nature  of, 
202. 

Congestion,  passive,  35. 
:  Congestion  of  the  lungs,   symptoms 
i      of.   199- 
i  Congestion  of  the  lungs,  termination 

of,  201. 
1  Congestion,  treatment,  38, 
I  Congestion  of  the  lungs,  treatment  of, 
\      202. 

Congestion,  venous,  35. 

Contagious  diseases,  of  nose,  107. 

Convulsive  cough,  14S. 
,  Coryza,  81. 


Index. 


405 


Coryza,  causes  of,  82. 

Corjza,  course  of,  S3. 

Coryza  iu  cattle,  85. 

Coryza  in  dog,  85. 

Coryza  in  horse,  81. 

Coryza  in  pig,  85. 

Coryza  iu  sheep,  85. 

Coryza,  symptoms  of,  82. 

Coryza,  treatment  of,  83. 

Coryza,  treatment  of  chronic,  90. 

Cough,  150. 

Cough,  abortive,  151. 

Cough,  auscukation  of,  174. 

Cough,  broken,  151. 

Cough,  convulsive,  148. 

Cough,  croupous,  151. 

Cough,  dry,  151. 

Cough,  humid,  151. 

Cough,  husky,  151. 

Cough,  loud,  151. 

Cough  of  dog,  150 

Cough  of  horse,  150. 

Cough  of  ox,  150. 

Cough  of  sheep,  150. 

Cough,  paroxysmal,  151. 

Cough,  rasping,  151. 

Cough,  rattling,  151. 

Cough,  short,  151. 

Cough,  small,  151. 

Cough,  soft,  151. 

Cough,  strong,  150. 

Cough,  symptomatic,  151. 

Cough,  weak,  151. 

Crepitation,  173. 

Crepitation,  modified,   173. 

Croup,  128 

Croup  in  sheep,  131. 

Croup  in  the  horse,  132. 

Croup  in  the  ox,  128. 

Croupous  bronchitis  in  cattle,  197. 

Croupous  bronchitis  in  sheep,  197. 

Croupous  cough,  151. 

Croupous  exudate,  52. 

Croupous  laryngitis,  128. 

Croupous  pneumonia,  213. 

Croupous  pneumonia, exciting  causes, 

215- 

Croupous  pneumonia  in  fowls,  238. 
Croupous  pneumonia  iu  sheep,  236. 
Croupous  pneumonia  in  the  ox,  233. 
Croupous    pneumonia,    predisposing 

causes,   214. 
Cynanche,  114. 
Cynanche  pharyngea,  126. 
Cysticercus  cellulosa  in  heart,  342. 
Cysticercus  tenuicoUis  in  heart,  342. 
Cysts  in  nose,  100. 


j  Death  beginning  at  brain,  5. 
I  Death  beginning  at  lungs,  4. 
1  Death  from  old  age,  5. 

Death  from  syncope,  4. 

Death  of  cells,  41. 

Death  of  tissue,  41. 

Death,  molecular,  4. 

Death,  partial,  4. 

Degeneration,  fatty,  340. 

Determination  of  blood,  active,  33. 

Determination  of  blood,  arterial,  33. 

Defervescence,  61. 

Diagnosis,  history  of  the  attack  in,  16. 

Diagnosis,  means  of,  16. 

Diagnosis,  medical,  16. 

Diagnosis,  objective  symptoms  in,  16. 

Diagnosis,   usual   state   of  health   of 
subject,  16. 

Diapedesis,  47. 

Diaphoretics,  66. 

Diaphragm,  position  of  in  dog,  157. 

Diaphragm,  position  of  in  horse,  156. 

Diaphragm,  position  of  in  ox,  156. 

Diaphragm,  position  of  in  pig,  157. 

Diplococcus  pneumonias  equina,  217. 

Disease,  causes  of,  7. 
j  Disease,  definition  of,  2. 
I  Disease,  exciting  causes  of,  9. 
I  Disease,  extrinsic  causes  of,  9. 

Diseases,  infectious  of  the  throat,  149. 

Diseases  of  nose,  107. 

Diseases  of  the  chest,  150. 
I  Diseases  of  the  lungs,   177. 
I  Diseases  of  the  nose,  78. 
!  Diseases  of  the  respiratory  organs,  72. 
;  Diseases,  parasitic  of  the  nose,  108. 
j  Disease,  percussion  in,  161. 
]  Disease,  predisposing  causes  of,  7. 

Distemper,  114. 

Dog,  auscultation  of,  168. 

Dog,  bronchial  asthma  in,  270. 

Dog,  bronchitis  in,  195. 

Dog,  coryza  in,  85. 

Dog,  laryngitis  in,  126. 

Dog,  nasal  catarrh  in,  113. 

Dog,  percussion  in,  161. 

Dog,  position  of  diaphragm  in,  157. 

Dog,  position  of  heart  in,  157. 

Dog,  pleurisy  in,  257. 

Dog,  pneumonia  in,  237. 

Dropsy,  ansemic,  377. 

Dyspticea,  274. 

D\-spncea  laryngea,  133. 

EcHiNOCOCCUS   veteriuorum   in   the 

heart,  341. 
Embolism,  345,  347,  350- 


4o6 


Index. 


Etnpyema,  266. 

Emphysema,  interlobular,  280. 
Emphysema,  vesicular,  2S0. 
Endocarditis,  331. 
Epistaxis,  78. 
Epistaxis,  causes  of,  78. 
Epistaxis,  symptoms  of,  79. 
Epistaxis,  treatment  of,  79. 
Erysipelas,  361. 
Etiology,  7. 
Expectoration,  152. 
Exudation,  49. 

Facies,  25. 

False  nostril,  abscess  of,  92,  97. 

Fatty  degeneration,  57. 

Fatty  degeneration  of  the  heart,  340. 

Fatty  tumors  in  nose,  99. 

Fever,  59. 

Fever,  adynamic,  68. 

Fever,  alkalies  in,  67. 

Fever,  antipyretics  in,  67. 

Fever,  cold  baths  in,  65. 

Fever,  cold  stage,  60. 

Fever,  convalescence  in,  67. 

Fever,  defervescence,  61. 

Fever,  definition  of,  59. 

Fever,  diaphoretics  in,  66. 

Fever,  diuretics  in,  66. 

Fever,  general  bleeding  in,  63. 

Fever,  hot  stage,  60. 

Fever,  laxatives  in,  66. 

Fever,  local  bleeding  in,  64. 

Fever,  premonitory  symptoms  of,  60. 

Fever,  production  of  waste  matters  in 
the  system  in,  61. 

Fever,  regimen,  62. 

Fever,  remedies,  63. 

Fever,  resolvents  in,  67. 

Fever,  retention  of  water  in  the  fe- 
vered system,  61. 

Fever,  sedatives  in,  66. 

Fever,  stimulants  in,  67. 

Fever,  symptoms  of,  59. 

Fever,  temperature,  61. 

Fever,  tonic  refrigerants  in,  67. 

Fever,  treatment  of,  62. 

Fever,  types  of,  62. 

Fever,  typhoid,  condition  in,  61. 

Fever,  warm  baths  in,  64. 

Fibrinous  exudate,  51. 

Filaria  imniitis,  342. 

Filaria  papillosa  hsematica,  342. 

Firing  in  advnamic  inflammation,  70, 
Firing  in  inflammation,   70. 

Flank,  double  action  of,  153. 
Foreign  body  in  nose,  94. 


Fowls,  croupous  pneumonia  in,  238. 
Frontal  sinuses  in  cattle,  catarrh  of, 


Gangrene,  58. 

Gangrene,  in  pneumonia,  226. 

Glander  nodules  in  heart,  341. 

Glottidis,  oedema,  147. 

Goat,  auscultation  of,  168. 

Granular  degeneration,  41. 

Granulation,  56. 

Granule  corpuscles,  56. 

Granule  masses,  56. 

Grub  in  head,  no. 

Guttural  pouches,  abscess  of,  94. 

Gutturomycosis  of  solipedes,  149. 

H/EMOPHII.IA,  366. 

Haemoptysis,  209. 

Hcemorrhage,  365. 

Haemorrhage  from  the  nose,  78. 

Haemorrhagic  infarction,  211. 
j  Healing  by  adhesion,  56. 

Healing  by  first  intention,  56. 
I  Healing  by  second  intention,  56. 

Health,  definition  of,  3. 
I  Heart,  abscess  in,  338. 
I  Heart,  atheroma  of,  344. 

Heart,  cancer  of,  341. 

Heart,  calcified,  344. 
,  Heart,  cartilaginous  degeneration  of, 
338. 

Heart,  chronic  disease  of,  339. 

Heart,  congenital  malformations  and 
displacements  of,  313. 

Heart,  cysticercus  cellulosa  in,  342. 

Heart,  cysticercus  tenuicoUis  in,  342. 

Heart,  diffuse  suppuration  in,  338. 

Heart,  dilatation  of,  323. 

Heart  disease,  general  symptoms  of, 

i      305- 

Heart,  diseases  of,  291. 

Heart,  echinococcus  in,  341. 

Heart,  fatty  degeneration  of,  340. 

Heart,  fibrous  degeneration  of,  33S. 

Heart,  filaria  in,  342. 

Heart,  functional  irregularity  of,  312. 

Heart,  glander  nodules  in,  341. 

Heart,  hypertrophy  of,  315. 

Heart,  induration  of,  33S. 

Heart,  inflammations  in,  325. 

Heart,  melanosis  of,  341. 

Heart,  morbid  sounds  of,  303. 
■  Heart,  neoplasms  of,  341. 

Heart,  osseous  degeneration  of,  338. 
;  Heart,  polypus  in,  338. 

Heart,  position  of,  292. 

Heart,  position  of  in  dog,  157. 


Index. 


407 


Heart,  position  of  in  horse,  155. 

Heart,  position  of  in  sheep,  157. 

Heart,  Rainey's  cj'sts  in,  342. 

Heart,  relative  position  of  in  the  do- 
mestic animals,  155. 

Heart,  rupture  from  concussion,  343. 

Heart,  rupture  from  exertion,  343. 

Heart,  rupture  from  pithing,  343. 

Heart,  rupture  of,  343. 

Heart,  sarcocysts  in,  342. 

Heart,  softening  of,  33S. 

Heart,  sounds  of,  301. 

Heart,  strongyli  in,  342. 

Heart,  structure  of,  293. 

Heart,  table  contrasting  symptoms  of 
hypertrophy  and  dilatation,  319. 

Heart,  table  of  murmurs  of,  304. 

Heart,  thickness  of  the  walls,  295. 

Heart,  trichina  in,  342. 

Heart,  tubercle  of,  341. 

Heart,  ulceration  of,  338. 

Heart,  ulceration  of,  343. 

Heart,  valviilar  disease  of,  339. 

Heart,  varicose  veins  in,  341. 

Heart,  weight  of,  296. 

Heart,  weight  of,  317. 

Heaves,  274. 

Hemiplegia  laryngea,  133. 

Hereditary  roaring,  141. 

Hodgkiu's  disease,  382. 

Horse,  acute  bronchitis  in,  178. 

Horse,  acute  pleurisy  in,  239. 

Horse,  asthma  in,  273 

Horse,  auscultation  of,  166. 

Horse,  chronic  bronchitis  in,  191. 

Horse,  croup  in,  132. 

Horse,  laryngitis  in,  115. 

Horse,  nasal  catarrh  in,  113. 

Horse,  percussion  of  chest  in,  159. 

Horse,  pneumonitis  in,  213. 

Horse,  position  of  chest  in,  155. 

Horse,  position  of  diaphragm  in,  156. 

Horse,  position  of  heart  in,  155. 

Horse,  position  of  intestines  in,  156. 

Horse,  position  of  liver  in,  156. 

Horse,  position  of  lung  in,  156. 

Horse,  position  ot  pancreas  in,  156. 

Horse,  position  of  spleen  in,  156. 

Horse,  position  of  stomach  in,  156. 

Hydrosemia,  371. 

Hydrothorax,  259. 

Hydrothorax,  symptoms  of,  260. 

Hydrothorax,  treatment  of,  261. 

Hyperseniia,  33. 

Hypergemia,  definition  of,  33. 

Hyperaeinia,  pulmonary,  198. 

Hyperasmia,  results  of,  35. 

Hyperaemia,  symptoms,  35. 


Hypersesthesia,  laryngeal,  148. 
Hypertrophy  of  the  heart,  315. 

lOAC  arteries,  embolism  of,  354,  355. 
Induration  of  the  heart,  338. 
Infarction,  hsernorrhagic,  211. 
Infectious  diseases  of  the  throat,  149. 
Inflammation,  39. 
Inflammation,  abscess  in,  71. 
Inflammation,  adynamic,  68. 
Inflammation,  blistering  in,  70. 
Inflammation,  co'd  applications  in, 69. 
Inflammation,  definition  of,  39. 
Inflammation,  firing  in,  70. 
Inflammation,  forms  of,  41. 
Inflammation,  hot  applications  in,  69. 
Inflammation,  local  treatment  of,  69. 
Inflammation,  massage  in,  71. 
Inflammation  of  the  lungs,  212. 
Inflammation,  products  of,  52. 
Inflammation,  results  of,  52. 
Inflammation,  rubbing  in,  71. 
Inflammation,  suppuration  in,  71. 
Inflammation,  treatment  of,  62. 
Inflammatory,  new  formations,  53. 
Influenza,  114. 
Innervation,  changes  in,  44. 
Intermittent  roaring,  141. 
Interstitial    development    of    lyniph 

into  tissue,  57. 
Intestines,  position  of  in  horse,  156. 
Inverterate  roaring,  causes  of,  134. 

Laryngea,  cynanche,  115. 
Laryngea,  dyspnoea,  133. 
Laryngea,  hemiplegia,  133. 
Laryngeal  hypenx'sthesia,    148. 
Laryngeal  polypi,  132. 
Laryngitis,  114. 
Laryngitis,  angina,  115. 
Laryngitis,  chronic,  117. 
Laryngitis,  croupous,  128. 
Laryngitis  in  the  dog,  126. 
Laryngitis  in  the  horse,  115. 
Laryngitis  in  sheep,  123. 
Laryngitis  in  pig,  124. 
Laryngitis,  pseudo-membranous,  12S. 
Laryngitis,  sub-acute,   117. 
Laryngitis,  treatment  of  chronic,  121. 
Laryngo-pharj'ugitis  in  cattle,  122. 
Larynx,  inflamed,  114. 
Larva   in    head,     morbid    symptom 

caused  by,  no. 
Larva  in  nasal  sinuses  of  sheep,  109. 
Larva,  mature,  no. 
Larva,  oestrus,  149. 
Larva,  of  oestrus  ovis,   109. 
Larva,  young,  no. 


4o8 


Index 


Leeches,  149. 

Leech  bites,  108 

Leucocytheinia,  379. 

LeukiLMiiia,  379. 

Linguatula  taenioides,  nasal  catarrh 
from,  1 13. 

Liver,  position  of  in  horse,  156. 

Liver,  position  of  in  ox,  156 

Lnng,  abscess  of  in  pneumonia,  225. 

Lunjj^,  collapse  of,  206. 

Lungs,  congestion  of,  198. 

Lungs,  diseases  of,  177. 

Lungs,  inflammation  of,  212. 

Lungs,  parasites  of,  290. 

Lungs,  position  of  in  horse,  156 

Lungs,  position  of  in  ox,  156. 

Lungs,  position  of  in  sheep,   157. 

Lungs,  relative  positions  of  in  the  do- 
mestic animals,  155. 

Lymphadenitis,  400. 

Lymphadenoma.  3S2. 

Lymphangiectasis,  397. 

Lymphangitis,  acute,  3S6. 

Lymphangitis,  infective,  392. 

Lviiiphangitis  of  plethora,  386. 

Lymphangitis,  traumatic,  392. 

Lymphatics,  dilated,  397. 

Lyniph-glands,  inflammation  of,  400 

Lyniphorrhagia,  399. 

Lymphorrhoea,  399 

Lvmph,  interstitial  development  into 
tissue,  57. 

Mai<ignant  catarrh,  105. 

Massage  in  adynamic  inflatnmalion. 

Massage  in  inflammation,  71. 
Medical  diagnosis,   16. 
Melanaemia,  378. 
Melanoses  of  the  heart,  341. 
Mensuration  of  chest,  175. 
Mesenteric  arteries,  embolism  of,  355. 
Mesenteric  glands,  diseases  of,  290. 
Metritis,  361. 
Microbes,  47. 
Micrococcus   pneumoniae    crouposte, 

217. 
Migration  of  white  blood  cells,  43. 
Monday  morning  disease,  386. 
Morbid  sounds,  152. 
Mucous  exudate,  50. 
Myocarditis,  338. 

Nasal  catarrh,  81. 

Nasal  catarrh,  chronic,  87. 

Nasal  discharge  from  carious  teeth,  93. 

Nasal  gleet,  87. 

Nasal  mucosa,  26. 


Nasal  polypus,  98. 

Nasal  sinuses  of  sheep,  larva  in,  109. 

Nasal  sinuses,  pus  in,  90. 

Neoplasms  in  nose,  98. 

Neoplasms  of  heart,  341. 

Nervous  disorder,  symptoms  of,  27. 

Noevus,  359. 

Noevus  in  heart,  341. 

Nose,  angioma  in,  100. 

Nose,  bleeding  from,  78. 

Nose,  carcinoma  in,  99. 

Nose,  contagious  diseases  of,  107. 

Nose,  cysts  in,  100. 

Nose,  diseases  of,  78. 

Nose,  neoplasms  in,  98. 

Nose,  osseous  tumors  in,  too. 

Nose,  parasitic  diseases  of,  loS. 

Nose,  sarcoma  in,  99. 

OCCASIONAI,  roaring,  141. 

CEdema  glottidis,  147. 

CEdema,  pulmonary,  204. 

CEstrus  larva,  149. 

CEstrus  ovis  in  nasal  sinuses  of  sheep, 

109. 
CEstrus  ovis,  larva  of,  109. 
CEstrus  purpureus,  112. 
Omasum,  position  of  in  ox,  156. 
Organs,  relative  positions  of  in  the 

domestic  animals,  155. 
Osseous  tumors  in  nose,  100. 
Ox,  auscultation  of,  167. 
Ox,  bronchitis  in,  193. 
Ox,  chronic  pneumonia  in,  235. 
Ox,  croup  in,  128. 
Ox,  croupous  pneumonia  in,  233. 
Ox,  percussion  of  chest  in,  159 
Ox,  position  of  abon)asum  in,  156. 
Ox,  position  of  diaphragm  in,  156. 
Ox,  position  of  liver  in,  156. 
Ox,  position  of  lungs  in,  156. 
Ox,  position  of  omasum  in,  156. 
Ox,  position  of  paunch  in,  156. 
Ozoeua,  87. 

Palpation,  175,  300. 
Palpitations,  307. 

Pancreas,  position  of  in  horse,  156. 
Paracentesis  thoracis,  261. 
Parasites  in  amcniia,  372. 
Parasites  of  the  air  passages,  290. 
Parasites  of  the  throat,  149. 
Parasitic  diseases,  of  the  nose,   108. 
Paroxysmal  cough,  151. 
Passive  congestion,  causes  of,  35. 
Passive  congestion,  results,  37. 
Passive  congestion,  symptoms,  37. 
Pathology,  definition  of,  i. 


Index. 


409 


Pathology,  (lefmiiion  of  general,  i. 

Pathology,  definition  of  special,  2. 

Paunch,  position  of  in  ox,  156. 

Percussion,  158,  300. 

Percussion,  immediate,  158. 

Percussion  in  birds,   161. 

Percussion  iu  disease.  161. 

Percussion  in  dog,  161. 

Percussion  in  p'g>,  160. 

Percussion  in  sheep,  i6o. 

Percussion,  mediate,    158. 

Pericarditis,  326. 

Pericarditis,  chronic,  32S. 

Perspiration,  suppressed,  75. 

Phagocytosis,  47,  48 

Pharyngeal  polypi,  132. 

Pharyngitis,  114,  126. 

Pharyngo-laryngitis  in  cattle,  122. 

Pliarynx,  114. 

Phlebitis,  360. 

Phlebitis,  adhesive.  361 

Phlebitis,  idiopatiiic,  360. 

Phlebitis,  suppurative,  361. 

Phlebolites,  364. 

Phlegmasia,  39. 

Phlogosis,  39. 

Pig.  auscultation  of,  16S. 

Pig,  coryza  iu.  85. 

Pig,  laryngitis  in,  124. 

Pig,  percussio  1  in,  160. 

Pig,  pneumonia  in,  237. 

Pig,  position  of  diaphragm  in,  157. 

Plethora,  369. 

Plelliora,  lymphangitis  of,  3S6. 

Pleura,  air  in,  265. 

Pleura,  parasites  of,  290. 

Pleurisy,  causes  of,  239. 

Pleurisy,  chronic,  267. 

Pleurisy,    classification    of  cases    in, 

246 
Pleurisy,  dry,  247. 
Pleurisy,  fibrinous,  247. 
Pleurisy  in  dog,  257. 
Pleurisy  in  cattle,  25  V 
Pleurisy  in  horse,  239. 
Pleurisy  in  sheep,  256. 
Pleurisy,  pleuritic  effusion  in,  246. 
Pleurisy,  post  mortem  appearances  in, 

244.  " 
Pleuris}',  prognosis  of,  249. 
Pleurisy,  sero  fibrinous,   247. 
Pleurisy,  sero  fibrino-purulent,  248. 
Pleurisy,  symptoms  of.  241. 
Pleurisv,  treatment  of,  249. 
Pleuritis,  239. 
Pleurodj'nia,  269. 
Pleuropneumonia,  258. 
Plugging  the  nose.  79. 


Pneumonia,  212. 

Pneumonia,  abscess  in,  223. 

Pneumonia,  abscess  of  the  lung  in, 
■225. 

Pneumonia,  antiphlogistic  treatment 
I      of,   228. 

i  Pneumonia,  antipyretic  treatment  in, 
230. 

Pneumonia,  auscultation  in,  220. 

Pneumonia,  bacteriology  of,  216. 

Pneumonia,  chronic,  232. 

Pneumonia,  compresses  in,  231. 

Pneumonia,  consolidation  in,  224. 

Pneumonia,  contagion  in,   216. 

Pneumonia,  croupous,  213. 

Pneumonia,  croupous  in  fowls,  238. 

Pneumonia,  death  in,  223. 

Pneumonia,  derivatives  in,  231. 

Pneumonia,  fomentations  in,  231. 

Pneumonia,  gangrene  in,  224,  226. 

Pneumonia,  gray  hepatisation  in,  225. 

Pneumonia  in  the  dog,  237. 

Pneumonia  in  the  ox.  chronic,  235. 

Pneumonia  in  the  ox,  croupous,  '23'?. 

Pneumonia  in  the  ox,  treatment  of, 

235- 
Pneumonia  in  the  pig,  23S. 
Pneumonia  in   the  sheep,   croupous, 

236 
Pneumonia,  modifications  of  distant 

organs  in,  226. 
Pneumonia,  modifications  of  the  blood 

in,  226. 
Pneumonia,   pathological  lesions  in, 

224- 
Pneumonia,  percussion  in,  220. 
Pneumonia,  jioultices  in,  231. 
Pneumonia,  progress  of,  221. 
Pneumonia,  red  hepatisation  in,  224. 
Pneumonia,  refrigerant  febrifuge  in, 

23  r . 
Pneumonia,  resolution  in,   223. 
Pneumonia,  sedatives  in,  231. 
Pneumonia,  splenisation  in,  223. 
Pneumonia,  stimulants  in,  231. 
Pneumonia,  sub-acute,  222. 
Pneumonia,  symptoms  of,  219. 
Pneumonia,  treatment  of,  227. 
Pneumonitis,  212. 
Pneumonitis  in  the  horse,   213. 
Pneumothorax,  265. 
Pneumothorax,  symptoms  of,  265. 
Pneumothorax,  treatment  of,  266. 
Polynemia,  369. 
Polypi,  laryngeal,  132. 
Polypus  in  the  heart,  338,  341. 
Polypus,  nasal,  98. 
Polypus  of  the  bronchial  tubes,  289. 


4IO 


Index. 


Polypi,  pharyngeal,  132. 
Prevention,  31. 
Prognosis,  28. 

Prognosis,  causes  of  illness,  29. 
Prognosis,  definition  of,  28. 
Prophylactics,  31. 
Prophylaxis,  31. 

Pseudo-membranous  laryngitis,  128. 
Pulmonary  apoplexy,  211. 
Pulmonary  hypertemia,    198. 
Pulmonary  oedema,  204. 
Pulmonary  oedema,  physical  signs  of, 

205. 
Pulmonary  oedema,  prognosis  of,  205. 
Pulmonary  oedema,  symptoms  of,  205. 
Pulse,  23,  296. 
Pus,  55. 
Pyo- pneumothorax,  266. 

Rabbits,  coccidian  catarrh,  108. 

Rainey's  cysts  in  the  heart,  342. 

Rales,  171. 

Rales,  bronchial,  171. 

Rale,  crepitant,  172. 

Rale,  drj',  171. 

Rale,  mucous,  172. 

Rale,  sibilant,  171,  172. 

Rale,  sonorous,  171. 

Rale,  subcrepitant,  173. 

Rale,  submucous,  172. 

Red  cells,  44. 

Resolution,  53. 

Resonance,  absence  of,  162. 

Resonance,  diminished,  162. 

Resonance,  increase  of,  161. 

Respiration,  24. 

Respiration,  Cheyne-vStokes,  340. 

Respiration,  creaking  sound  in,  174. 

Respiration,  friction  sound  in,  173. 

Respiration,  gurgling  sound  of,  174. 

Respiration,  juvenile,  165. 

Respiration,  metallic  tinkling  in,  174. 

Respiration,  modification  of,  153. 

Respiration,  slow,  153. 

Respiration,  splashing  sound  of,  174. 

Respiration,  tardy,  153. 

Respiratory  disease,  affected  by  age, 
70. 

Respiratory  disease,  affected  by  sea- 
son, 77. 

Respiratory  diseases,  general  causes, 
72. 

Respiratory  mucosa,  extent  of,  72. 

Respiratory  murmur,  absence  of,  170. 

Respiratory  murmur,  diminution  of, 
169. 

Respiratory  murmur,  general  dimniu- 
tion  of,  170. 


Respirator}'  murmur,  increase  of,  169. 

Respiratory  murmur,  partial  diminu- 
tion of,  170. 

Respiratory  organs,  diseases  of,  72. 

Retention  of  water  in  the  fevered  sys- 
tem, 61. 

Rheumatic  endocarditis,  337. 
'  Rhinaria    taenioides,    nasal    catarrh 
from,  113. 

Rhinitis,  81. 

Roaring,  133. 

Roaring,  hereditary,  141. 

Roaring,  immediate  cause  of,  136. 

Roaring,  intermittent,  141. 

Roaring,  inveterate,  causes  of,  134. 

Roaring,  occasional,  141. 
!  Roaring,  temporary,  causes  of,  134. 
!  Rupture  of  the  heart,  343. 

Sarcoma  in  nose,  99 
I  Sarcocysts  in  the  heart,  342. 

vScarlatina,  114. 

Senieiology,  18. 

Serous  exudate,  50. 
I  Sheep,  ausculation  of,  16S. 

Sheep  bot  fly,  109. 

Sheep,  coryza  in,  85. 
j  Sheep,  croup  in,  131. 

Sheep,  croupous  bronchitis  in,  197. 
j  Sheep,  croupous  pneumonia  in,  236. 

Sheep,  laryngitis  in,  123. 

Sheep,  percussion  in,  160. 

Sheep,  pleurisy  in,  256. 

Sheep,  ]iosition  of  the  heart  in,  157. 

Sheep,  posiiion  of  lung  in,  157. 

Skin  symptoms,  24. 

Softening,  result  of  inflammation,  57. 

Solipedes,  gutturoniycosis  of,  149. 

Sore  throat,  114,  126. 

vSore  throat,  croupous,  114. 

Sore  throat,  diphtheritic,  114. 

Spleen,  position  of  in  horse,  156. 

Stomach,  position  of  in  horse,  156, 

Strangles,  114. 

Strongylus  subulatus,  342. 

Strongylus  vasorum  in  the  heart,  342. 

Study,  objects  and  methods  of,  i. 

Suppuration,  53. 

Suppuration  in  adynamic  inflamma- 
tion, 71. 

Suppuration  in  inflammation,  71. 

Suppuration  in  nasal  sinuses,  90. 
1  vSymptonmtology,  18. 

Symptomatic  cough,  151. 

!  Symptoms,  constitutional,  18. 

Symptoms,  definition,  18. 
■    Symptoms,  direct,  19.  « 

!  Symptoms,  facies,  25. 


Index. 


411 


vSymptoms,  idiopathic,  19. 
Syniptouis,  indirect,  19. 
Syinptotus,  local,  iS. 
Symptoms,  movements,  20. 
vSymptoms,  objective,  18. 
S3'mptoms  of  coryza,  82. 
Symptoms  of  nervous  disorder,  27. 
Symptoms,  position,  20. 
vSymptoms,  precursory,  19. 
Symptoms,  premonitory,  19 
Symptoms,  skin,  24. 
vSymptoms,  subjective,  iS. 
Symptoms,  sympathetic,  19. 

Tapping  the  chest,  261. 
Temperature  in  disease,  22. 
Temperature,  normal,  22. 
Temporary  roaring,  causes  of,  134. 
Therapeutics,  32 
Thoracentesis,  261. 
Throat,  affections  of,  114. 
Throat,  infectious  diseases  of,  149. 
Throat,  parasites  of,  149. 
Thrombosis,  350. 
Touch,  175. 


Tracheotomy,  119,  131. 

Traumatic  catarrh,  loi. 

Treatment,  32. 

Treatment  of  chronic  coryza,  87,  90. 
!  Treatment  of  epistaxis,  79. 
'  Treatment  of  frontal  catarrh,  102. 

Trichina  in  the  heart,  342. 

Tubal  sound,   170. 

Tubercle  in  heart,  341. 

Ulceration,  57. 
Ulceration  of  the  heart,  33S. 

Varicose  veins,  363. 

Veins,  calcareous  bodies  in,  364. 

Veins,  varicose,  363. 

Vena  azygos,  rupture  of,  343. 

Ventricles,  internal  capacity  of,  296. 

Vesicular  murmur,  general  increase 

of,  169. 
Vesicular  murmur,  partial  increase  of, 

169. 

White  blood  cells,  migration  of,  43. 
Winds,  carry  disease,  76. 


Webster  Family  Library  of  Veterinary  Medicine 
Cummings  Sciiool  of  Veterinary  Medicine  at 
Tufts  University 
200  Westboro  Road 
North  Grafton,  MA  01536 


